关节镜下带线锚钉固定治疗儿童髁间棘骨折12例分析

Arthroscopic fixation with the suture anchor in the treatment of intercondylar fracture in children:an analysis of 12 cases

目的 探讨关节镜下带线锚钉治疗儿童胫骨髁间棘骨折的临床疗效。方法 回顾分析2012年1月～2015年12月收治的12例儿童胫骨髁间棘骨折患者,在关节镜下复位,使用带线锚钉固定,观察手术前后Lysholm膝关节评分及临床表现。结果 术中关节镜下骨折均满意复位;术后行X线复查,12例患儿骨折端达解剖复位或近似解剖复位。无感染、皮肤坏死等并发症。所有患儿均获得随访6～36个月,平均8个月。术后6个月复查X线均示骨性愈合。末次随访时进行膝关节检查,所有患者膝关节屈伸功能正常,前抽屉试验和Lachman试验均呈阴性。Lysholm评分与术前比较显著提高,差异有统计学意义（P〈0.001）。结论 关节镜下带线锚钉固定治疗儿童髁间棘骨折,骨折端复位简单、固定牢靠、损伤小且避免二次手术取出内固定物,术后可早期行功能锻炼,有效恢复膝关节的功能。

Objective To explore clinical effects of arthroscopic fixation with the suture anchor in the treatment of intercondylar fracture in children.Methods A retrospective analysis was carried out on the clinical data of 12 children with intercondylar fracture admitted to hospital from January, 2012 to December, 2015.They were given reduction with arthroscopic fixation with the suture anchor.And then, Lysholm knee score and clinical manifestations before and after operation were observed. Results Satisfactory reduction was achieved during arthroscopic surgery.Postoperative X-ray examination showed that the 12 children obtained anatomical reduction or close to anatomical reduction. No infection, skin necrosis and other complications were found.All patients were followed up for 6 to 36 months （mean 8 months ）. X-ray examination showed bony union 6 months after operation. Knee examination at the last follow-up visit showed that extension and flexion function of all patients were normal, both anterior drawer test and Lachman test were negative.After operation, Lachman score significantly improved, difference was statistically significant（ P〈0.001 ）.Conclusion Arthroscopic fixation with suture anchor in the treatment of intereondylar fracture in children has many advantages like simple reduction, reliable fixation, little trauma, which can avoid to remove the internal fixation in the second operation.In addition ,patients can do early postoperative functional exercise ,which can effectively restore the function of the knee joint.