关节镜下带线锚钉固定治疗胫骨髁间嵴撕脱骨折的临床研究.docVIP

关节镜下带线锚钉固定治疗胫骨髁间嵴撕脱骨折的临床研究 李冀 李众利 廖伟雄 张浩 王克涛 杨以萌 解放军总医院骨科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 :观察关节镜下带线锚钉固定治疗胫骨髁间嵴撕脱骨折的疗效。方法 :对2012年7月至2015年1月行关节镜下带线锚钉固定技术治疗的22例胫骨髁间嵴撕脱骨折患者的临床资料进行了回顾性研究, 其中男12例, 女10例;平均年龄22.8岁 (1833岁) ;右膝9例, 左膝13例。从受伤到手术的平均间隔为6.8 d (311 d) 。根据改良Meyers-Mc Keever分型:Ⅱ型13例, Ⅲ型7例, Ⅳ型2例。通过关节活动度、Lysholm评分、IKDC 2000主观膝关节评分、轴移试验、前抽屉试验对术后临床疗效进行评价。结果:所有患者术后切口Ⅰ期愈合, 无相关并发症。22例均获得随访, 平均随访时间32.8个月 (1842个月) 。关节活动度由术前的 (49.37±7.69) °提高到末次随访时的 (126.38±5.58) ° (P0.01) ;Lysholm评分由术前的43.4±5.6提高到末次随访时的79.2±6.2 (P0.01) ;IKDC 2000评分由术前的52.6±6.2提高到末次随访时的81.4±5.7 (P0.01) 。末次随访时对患者进行体格检查, 1例术后18个月的患者轴移试验阳性, 前交叉韧带松弛Ⅱ级;1例术后24个月的患者前抽屉征弱阳性。结论:关节镜下带线可吸收锚钉固定技术治疗胫骨髁间嵴撕脱骨折可对骨折块提供精确的复位和牢固固定, 可应用于治疗包括粉碎性骨折的各种类型骨折, 并且无须二次手术取出内置物。 关键词： 膝关节; 骨折; 关节镜; 作者简介：李众利, E-mail:lizhongl301@163.com 收稿日期：2018-02-22 Clinical research on suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy LI Ji LI Zhong-li LIAO Wei-xiong ZHANG Hao WANG Ke-tao YANG Yi-meng Department of Orthopaedics, General Hospital of Chinese PLA; Abstract： Objective:To evaluate the early clinical effects of suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy. Methods:From July 2012 to January 2015, 22 patients with the avulsion fracture of tibial intercondylar eminence were treated with arthroscopic suture anchor fixation. There were 12 males and 10 females, with an average age of 22.8 years old (ranged, 18 to 33 years old) . Nine patients had the fractures in the right knee and 13 patients had the fractures in the left knee. The mean duration from injury to surgery was 6.8 days (ranged, 3 to 11 days) .According to the improved Meyers Mc Keever classification, 13 cases were typeⅡ, 7 cases were type Ⅲ, and 2 cases were typeⅣ. The clinical outcomes were evaluated by the range of motion, the Lysholm score, the IKDC 2000 subjective knee score, the axial shift t