关节镜下克氏针缝线张力带治疗胫骨髁间隆突骨折的疗效分析

Effectiveness of arthroscopic treatment with Kirschner wire suture tension band on the fixation of tibial intercondylar eminence fracture

目的探讨关节镜下克氏针缝线张力带治疗胫骨髁间隆突骨折的临床疗效。方法选取2017年10月-2019年9月该院收治的胫骨髁间隆突骨折患者13例,均采用关节镜下克氏针缝线张力带进行固定。其中,男7例,女6例;年龄13~48岁,平均(28.92±10.71)岁。术前Lachman试验和前抽屉试验均为阳性。所有患者术前术后采用Lysholm评分、国际膝关节文献委员会(IKDC)评分和X线检查进行评估。结果 13例患者均获得随访,随访6~12个月,平均(10.31±1.89)个月。术后X线检查显示骨折复位良好,均于术后3至4个月达到骨性愈合,平均(3.69±0.48)个月。随访中未发现感染、关节功能障碍和血管神经损伤等并发症。末次随访时,所有患者膝关节活动度恢复正常,前抽屉试验和Lachman试验均为阴性。患者末次随访时,Lysholm评分从术前的(36.46±4.89)分增加到(94.85±1.82)分(t=-46.77,P=0.000),IKDC评分从术前的(47.19±4.17)分增加到(87.92±3.79)分(t=-40.72,P=0.000),术前术后比较,差异均有统计学意义。结论关节镜下克氏针缝线张力带技术治疗胫骨髁间隆突骨折,具有手术创伤小、术后恢复快、操作简单、固定可靠和内固定耗材费用低的优点,疗效满意。

Objective To evaluate the clinical efficacy of arthroscopic treatment of tibial intercondylar eminence fracture with Kirschner wire suture tension band technique.Method Thirteen patients with tibial intercondylar protuberance fracture from October 2017 to September 2019 were selected as research objects.All of them were fixed by Kirschner wire suture tension band under arthroscopy.There were 7 male patients and 6 female patients with an average age of(28.92±10.71)years old(range,13~48 years).The results of Lachman and anterior drawer test were both positive.All the patients were evaluated with Lysholm score,International Knee Documentation Committee(IKDC)score and X-ray examination before and after operation.Results The mean duration of follow-up was(10.31±1.89)months(range,6~12 months)in all the patients.Postoperative X-ray showed good reduction of all the fractures,and the fractures were healed in(3.69±0.48)months on average(3~4 months).Infection,knee dysfunction,neurovascular injury were not found after surgery.All these cases were examined normal range of motion,negative Lachman test and anterior draw test at the end of the follow-up.Lysholm scores increased from(36.46±4.89)preoperatively to(94.85±1.82)at the last follow-up(t=-46.77,P=0.000),the IKDC score increased from(47.19±4.17)preoperatively to(87.92±3.79)(t=-40.72,P=0.000),there were significant difference before and after operation.Conclusion The arthroscopic treatment of tibial intercondylar eminence fracture with Kirschner wire suture tension band technique has the advantages of minimal invasive,quickly postoperative recovery,simple operation,reliable fixation,low cost of internal fixation consumables,and satisfactory curative effect.