关节镜下陈旧性胫骨髁间棘骨折的治疗.docxVIP

关节镜下陈旧性胫骨骨果间棘骨折的治疗 【摘要】探究关节镜辅助下陈旧性胫 骨骨果间棘骨折的治疗。［方法］15例陈旧性 胫骨骨果间棘骨折患者，15个膝，分为两组。 一组采用关节镜下钢丝固定；一组采用关节 镜下胫骨骨果间棘骨折清理并重建前交叉韧 带。观察骨折愈合情况和膝关节稳定性并行 Lysholm膝关节评分评价疗效。［结果］钢丝 固定组有6例，胫骨骨果间棘骨折清理并重建 前交叉韧带组有9例，随访时间：10?38个 月。钢丝固定组有1例术后3个月发生固定 钢丝断裂，其余5例均于术后6?8周愈合， 膝关节稳定性两组无差异。术后 6个月 Lysholm膝关节功能评分：钢丝固定组为土， 胫骨骨果间棘骨折清理并重建前交叉韧带组 为土，两组比较有统计学差异。 ［结论］陈 旧性胫骨棘骨折多由新鲜骨折治疗不及时 或治疗不当演变而来； 对于HI型以上的陈旧 性胫骨骨果间棘骨折或者受伤后时间较长的 陈旧性胫骨骨果间棘骨折患者，采用关节镜下 胫骨醒间棘骨折清理并一期施行前交叉韧 带重建手术，具有治疗时间短、膝关节功能 恢复快、临床疗效好等优点。 【关键词】胫骨醒间棘骨折陈旧性骨折 关节镜治疗 Abstract : [ Objective ] To investigate the treatment of old tibial eminence fractures under arthroscopy. [ Method [ Fifteen knees in 15 patients with old tibial eminence fractures were divided into two group were treated with arthroscopic reduction and wires fixation , the other group were treated arthroscopic anterior cruciate ligament observed the fracture healing with X ray, measured the stability of the knees and evaluated according to Lysholm knee score system. [ Result ] Six patients in arthroscopic reduction and wires fixation group (three cases of type H , three cases of type HI) and nin e patients in arthroscopic anterior cruciate ligament reconstruction group (two cases of type n , five cases of type HI and two cases of type IV) were followed up for 10 to 38 months (mean , 18 months).One case in arthroscopic reduction and wires fixation group was found wire breakage at three months after operation , and the bone healing time in the other five cases were 6 ? were no differences between two groups in the stability of the average Lysholm knee score were 士 in arthroscopic reduction and wires fixation group and 士 arthroscopic anterior cruciate ligament reconstruction group at 6 months after was statistically significance between the two groupsin Lysholm knee score. [Conclusion ] The old fractures are developed from fresh fractures because of misdiagnosis or anterior cruciate ligament reconstruction in type HI and type IV old tibial eminence fractures or in old tibial eminence