关节镜下同种异体骨-髌腱-骨重建前交叉韧带109-第三军医大学学报.doc

PAGE 关节镜下治疗胫骨髁间前棘撕脱骨折30例 陈加荣，杨 柳，戴 刚，郭 林 （第三军医大学西南医院关节外科中心，重庆 400038） 摘 要：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 对自2004年5月至2007年12月收治的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评分标准来评价疗效。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。 关键词：关节镜；空心拉力螺钉；胫骨髁间前棘；撕脱骨折 中图法分类号： 文献标识码：A Arthroscopic treatment for 30 cases of avulsion fracture of tibial intercondylar anterior eminence: report of 30 cases CHEN Jia-rong，, YANG Liu，, DAI Gang，, GUO Lin (The Center for jJoint Surgery，, Southwest Hospital, of the Third Military Medical University，, Chongqing 400038，, China) Abstract :Objective 　To discuss 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 Dec.ember 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 years. There were 12 fresh fractures and 18 old fractures. According to Meyers-McKeever-Zaricnyl’s classification systems, there were 8 cases of type = 2 \* ROMAN IIⅡ, 15 cases of type = 3 \* ROMAN IIIIII, and 7 cases of type = 4 \* ROMAN IVIV. Patients were encouraged to do postoperative rehabilitation, such as active joint extension and flexion, exercise of isometric contraction of quadriceps femoils. The treatment outcomes were evaluated by Lysholm and Irrgang knee score system．Results All patients were followed up for 3