关节镜下双通道双根线固定治疗胫骨髁间棘骨折疗效分析

Arthroscopic treatment of tibial intercondylar ridge avulsion fracture with double root line double tunnel fixation technique

目的:探讨关节镜下应用双通道双根线治疗胫骨髁间棘骨折的可行性及近期疗效。方法 :2012年5月至2017年6月对21例胫骨髁间棘骨折患者行关节镜下双通道双根线固定,其中男16例,女5例;年龄17～45岁,平均29.6岁;受伤至手术时间3～6 d,平均3.6 d。所有病例行关节镜探查,骨折复位,双通道双根线固定。术后3、6个月采用Lysholm膝关节评分评定膝关节功能,并通过X线片检查随访患者骨折愈合及复位情况。结果 :所有患者获得随访,时间7～23个月,平均12.8个月。术后所有患者骨折骨性愈合,膝关节活动度恢复良好,膝关节活动范围0°～130°,无患肢功能障碍。患者术后3、6个月的Lysholm膝关节评分分别为93.52±7.10,95.95±6.34。结论:关节镜下应用双通道双根线治疗胫骨髁间棘骨折,操作简便,疗效可靠,可为胫骨髁间棘骨折提供一种较为理想的内固定方法。

Objective：To discuss arthroscopic technique of double root line double tunnel fixation for tibial intercondylar ridge avulsion fracture and its short term followvup observational results. Methods：From May 2012 to June 2017,21 cases of tibial intercondylar ridge avulsion fractures were treated with arthroscope double line double tunnel. Among the patients,16 males and 5 females were ranging in age from 17 to 45 years old,with an average of 29.6 years old,and injury to surgery time 3 to 6 days,with an average of 3.6 days. All the patients underwent arthroscopic exploration,fracture reduction,double root line fixation. The knee function was assessed at 3 and 6 months postoperatively using the Lysholm knee score,and the healing and resection of the patients were followed by X ray examination. Results：All patients were followed up for 7 to 23 months,with an average of 12.8 months. All patients after fracture were bone healing,knee activity were gained their previous normal levels（ranged,0° to 130 °）,and no limb dysfunction. The average scores of Lysholm knee were（93.52 ±7.10） and（95.95 ±6.34）points in 3 months and 6 months after operation. Conclusion：Arthroscopic treatment of tibial intercondylar ridge avulsion fractures with double root line is simple and reliable,and can provide an ideal internal fixation method for tibial intercondylar ridge avulsion fractures.