胫骨髁间棘撕脱骨折患者关节镜下带线锚钉治疗的临床研究(1)
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[摘要] 目的：探讨关节镜下带线锚钉治疗胫骨髁间棘撕脱骨折的手术方法和疗效。方法：回顾性分析本院2004年8月～2008年6月收治的采用关节镜下骨折复位，带线锚钉固定治疗新鲜胫骨髁间棘撕脱骨折27例临床资料，按照Meyers-Mckeever胫骨髁间棘骨折分型：Ⅱ型16例，Ⅲ型11例。结果：27例获随访，随访时间5～27个月，平均16.7个月。所有患者骨折全部愈合，膝关节无不稳症状，术后参照Lysholm评分95～100分，平均97.3分。结论：关节镜下带线锚钉治疗胫骨髁间棘撕脱骨折，手术创伤小，手术方法简便易行，固定牢固，避免固定物的取出，可允许患者早期行走及进行积极的康复训练。
[关键词] 关节镜；前交叉韧带；骨折固定术；临床研究
[中图分类号] R683.42 [文献标识码] A [文章编号] 1674-4721(2011)12(b)-038-03
The clinical study of avulsion fracture of tibial eminence treated by suture anchors under arthroscopy
LIU Xudong, JIANG Shengbo, WU Jian, YAO Li, MA Keyong
Department of Joint Surgery of the First People's Hospital of Lianyungang (Clinical Medical School of Xuzhou Medical College) , Jiangsu Province, Lianyungang 222000, China
[Abstract] Objective: To explore the surgical skill and the effectiveness of avulsion fracture of tibial eminence treated by suture anchors under arthroscopy. Methods: The clinical data of 27 patients with fresh avulsion fracture of tibial eminence (typeⅡ in 16 cases and typeⅢ in 11 cases) which were treated with reduction and internal fixation by suture anchors under arthroscopy were collected from Aug. 2004 to Jun. 2008 with a retrospective analysis. Results: 27 cases had been followed up for 5-27 months (average of 16.7 months). The fractures were all healed without symptom of displacement and nonunion. No knee joint relaxation or extension-restriction was found. The Lysholm score ranged from 95 to 100 with a mean of 97.3 postoperatively. Conclusion: The reduction and internal fixation of avulsion fracture of tibial eminence treated by suture anchors under arthroscopy is a technique of minimal trauma, easy-to-use, reliable fixation and avoiding the fixation out, allowing patients to have early walking and rehabilitation training.
[Key words] Arthroscopy; Anterior cruciate ligament; Fracture Fixation; Clinical study
胫骨髁间棘撕脱骨折是前交叉韧带(ACL)损伤的一个类型，对于Meyers和McKeever分型Ⅱ、Ⅲ型的撕脱骨折主张进行手术治疗[1]。常规的切开复位固定手术，手术创伤较大，且常需二次手术进行内固定物的取出。笔者自2004年8月～2008年6月采用关节镜下手术，带线锚钉固定的方法治疗该类损伤27例，疗效满意。
1 资料与方法
1.1 一般资料
本组资料根据本院2004年8月～2008年6月收治的采用关节镜下骨折复位，带线锚钉固定治疗新鲜胫骨髁间棘撕脱骨折27例，男19例，女8例，年龄19～62岁，平均34.5岁。均为新鲜骨折，表现为关节肿胀，积血及伸膝受限，Lachman征阳性。Lysholm评分(54 ......
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