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纸质出版:2009
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陈加荣,杨柳,戴刚,郭林.关节镜下治疗胫骨髁间前棘撕脱骨折30例[J].陆军军医大学学报(原第三军医大学学报),2009,31(07):626-628.
CHEN Jia-rong,YANG Liu,DAI Gang,GUO Lin.Arthroscopic treatment for avulsion fracture of tibial intercondylar anterior eminence: report of 30 cases[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(07):626-628.
目的 讨论关节镜辅助下治疗胫骨髁间前棘撕脱骨折的手术方法及临床疗效。 方法 2004年5月至2007年12月我科对收治的30例胫骨髁间前棘撕脱骨折患者行关节镜下胫骨髁间前棘撕脱骨折复位、空心拉力螺钉内固定术,其中男性20例,女性10例,年龄15~79岁,平均年龄32.0岁;急性损伤12例,陈旧性损伤18例;按Meyers-McKeever-Zaricnyl’s分型:Ⅱ型8例,Ⅲ型15例,Ⅳ型7例。术后行患肢股四头肌功能锻炼及主动伸屈关节锻炼。出院后通过随访信及门诊复查方式给予随访,采用Lysholm及Irrgang评分标准评价疗效。 结果 30例患者术后均获随访,时间3~60个月,平均31.2个月。术后2个月复查X线片均见骨性愈合,患者无主观膝关节不稳感,与健侧对比Lachman 试验、前抽屉试验、轴移试验均为阴性,关节屈伸活动恢复正常,Lysholm评分由术前(60.8±1.5)分增至(95.5±3.5)分,Irrgang评分由术前(55.5±3.3)分增至(90.5±2.5)分。 结论 关节镜辅助下用空心拉力螺钉治疗髁间前棘撕脱骨折,是一种创伤小、固定可靠、操作方便快捷、疗效确实的方法。
Objective To investigate the outcomes of arthroscopic reduction and internal fixation with cannulate lag screw for avulsion fracture of tibial intercondylar anterior eminence. Methods From May 2004 to December 2007
30 cases of tibial intercondylar anterior eminence avulsion fracture were treated by arthroscopic reduction and fixation with cannulated lag screw. Among the patients
there were 10 females and 20 males
ranging from 15 to 79 years old with an average age of 32.0. There were 12 fresh fractures and 18 old fractures. According to Meyers-McKeever-Zaricnyl’s classification systems
there were 8 cases of type Ⅱ
15 cases of type Ⅲ
and 7 cases of type Ⅳ. Patients were encouraged to do postoperative rehabilitation
such as active joint extension and flexion
exercise of isometric contraction of quadriceps femoris. The treatment outcomes were evaluated by Lysholm and Irrgang knee score system. Results All patients were followed up for 3 months to 60 months (averaging 31.2 months). X rays revealed bony healing 2 months after operation . The joints were stable. Negative Lachaman and drawer and jerk tests were found in all cases
and there was no dysfunction in the knee joints. Lysholm scores were increased from (60.8±1.5) to (95.5±3.5) while Irrgang scores increased from (55.5±3.3) to (90.5±2.5). Conclusion Arthroscopic treatment of avulsion fracture of tibial intercondylar anterior eminence is an easy approach with minimal invasion
and has reliable reduction and fixation with satisfied results.
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