关节镜下微创治疗对胫骨髁间棘骨折的疗效

目的 探讨关节镜下复位不同内固定方法治疗胫骨髁间棘撕脱性骨折的疗效.方法 采用关节镜下治疗胫骨髁间棘撕脱性骨折83例,其中Ⅱ型27例,Ⅲ型38例,Ⅳ型18例.在关节镜监视下行骨折复位、利用前交叉韧带胫骨导向器准确确定骨床上的钻孔位置;于胫骨结节内下部经皮向关节腔钻入一个骨隧道;采用双股5号尼龙编织缝线套扎前交叉韧带基底并经骨隧道引出关节外固定于胫骨结节内侧门型钉上.结果 术后83例获得随访6～36个月,平均15个月.术后Lachman和抽屉试验均为阴性.X线片显示除2例骨块前缘有2 mm上撬外均为解剖复位,骨折全部愈合.膝关节活动均正常.结论 关节镜下复位及双股尼龙编织缝线套扎固定治疗胫骨髁间棘撕脱骨折,复位满意、固定可靠;该手术方法简便易行,创伤小,有利于膝关节功能恢复.

Arthroscopic Surgery for Treatment of Tibial Intercondylar Eminence Fractures

Objective To evaluate the clinical efficacy of arthroscopic reduction and fixation in the treatment of tibial intercondylar eminence fractures.Methods A total of 83 cases of tibial intercondylar eminence fractures（27 type Ⅱ,36 type Ⅲ,and 20 type Ⅳ） were arthroscopically reduced and fixed with the anterior cruciate ligament drill guide.The tibial bone was countersunk fixed with double-stranded braided No.5 sutures through tibial tunnel.Results After 6 to 36 months of follow-up（average 15 months）,drawer and Lachman tests were negative and all fractures were healed radiographically.Knee joint motion was normal in all patients.Conclusion Arthroscopic reduction and Ethibond suture fixation of tibial intercondylar eminence fractures provides satisfactory reduction and stable fixation with minimal invasion and earlier rehabilitation.