关节镜下固定移位的胫骨髁间嵴撕脱性骨折

目的探讨关节镜下应用钢丝固定移位的胫骨髁间嵴撕脱性骨折的临床效果。方法自2003年1月至2010年12月对35例移位的胫骨髁间嵴撕脱性骨折患者在关节镜下应用钢丝固定,根据Meyers和McKeever分型,Ⅱ型17例,Ⅲ型14例,Ⅳ型4例。术后X线观察骨折愈合。根据Lysholm评分评价膝关节功能,配对t检验比较术前和随访末膝关节功能。结果平均随访时间（16.94±3.06）个月,无切口及关节内感染。术后X线检查显示骨折解剖复位,骨折平均愈合时间（11.91±4.30）周,随访末平均Lysholm评分（92.63±5.46）分,与术前（27.49±10.83）分比较,差异具有统计学意义（t=61.29,P〈0.05）。结论关节镜下应用钢丝固定移位的胫骨髁间嵴撕脱性骨折适用范围广,操作简单,具有创伤小,固定可靠,并发症少,关节功能恢复快,内固定物关节外取出方便的优点。

Arthroscopic fixation of displaced tibial intercondylar eminence avulsion fracture

Objective To investigate the clinical effects of arthroscopic fixation for displaced tibial intercondylar eminence avulsion fracture with steel wires.Methods From January 2003 to December 2010,35 patients with displaced tibial intercondylar eminence avulsion fracture were treated by arthroscopic fixation with steel wires.There were type Ⅱ fracture in 17 cases,type Ⅲ in 14 cases and type Ⅳ in four cases according to the Meyers and McKeever classification.The fracture union was observed by radiological examination.The knee functions were evaluated by Lysholm scores system and preoperative Lysholm scores were compared with postoperative Lysholm scores at the final follow-up by Paired-Sample T Test.Results The mean duration of follow-up was(16.94±3.06) months(range,12 months to 27 months).There was no incision or intra-articular infection in all cases.Radiological examination showed anatomical reduction in fracture sites at the final of follow-up.The mean healing time of fracture was(11.91±4.30) weeks.The Lysholm scores at the final of follow-up were(92.63±5.46) points,preoperative Lysholm scores were(27.49±10.83) points,and there was significant difference between them(t=61.29,P<0.05).Conclusions Arthroscopic fixation for displaced tibial intercondylar eminence avulsion fracture with steel wire can be applied to all types of avulsion fractures,and it does have advantages of simple technique,minimal invasion,stable fixation,fewer complications,earlier rehabilitation of knee joint,and convenience for fixator removal extra-articularlly.