关节镜下经套管钢丝固定治疗胫骨髁间前棘骨折的体会

目的分析关节镜下钢丝捆扎固定治疗胫骨髁间前棘骨折的临床疗效。 方法采用微创关节镜技术复位，克氏针钻孔后经套管法置入一道或两道钢丝捆扎固定治疗胫骨髁间前棘撕脱骨折20例，纳入标准为新鲜骨折，排除陈旧性骨折及复杂的胫骨平台骨折(SchatzkerⅡ型以上)，男12例，女8例，年龄18～65岁，平均(38.1±2.6)岁，交通伤14例，运动伤4例，砸伤2例。依据Meyers & Mckeever和Zaricznyj分型标准，Ⅱ型6例，ⅢA型10例，ⅢB型2例，Ⅳ型2例。 结果20例病人全部得到随访，随访时间12～26月，平均(15.5±2.1)月，所有骨折均愈合，采用Lysholm评分标准进行评分，得分为82～96分，平均(91±7)分。 结论关节镜下用钢丝捆扎固定治疗胫骨髁间前棘骨折，操作简便，固定牢靠，免除了二次关节镜取手术，是一种满意的治疗方法。

Arthroscopic treatment of tibial intercondylar anterior spine fracture with cannula and wire fixation

ObjectiveTo analyze the clinical effect of arthroscopic wire strapping fixation in the treatment of tibial intercondylar spine fracture. MethodsUsing the minimally invasive arthroscopic technique to restore the Kirschner wire after drilling through the casing method into one or two wire strapping fixed treatment of tibial intercondylar anterior avulsion fracture in 20 cases, Inclusion criteria were fresh fractures, excluding old fractures and complex tibial plateau fractures (serious than Schatzker type Ⅱ). Twelve males and eight females were enrolled, aged from 18 to 65 years, with a mean age of (38.1±2.6) years. Among them, 14 cases were traffic injuries, four cases were sports injuries, two cases were other injury. According to Meyers & Mckeever and Zaricznyj classification criteria, there were six cases of typeⅡ, 10 cases of type ⅢA, two cases of type ⅢB, and two cases of type Ⅳ. ResultsAll the patients were followed up for 12 to 26 months with an average time of (15.5±2.1) months. All the fractures were healed and scored by Lysholm score which was 82-96, (91±7) on average. ConclusionArthroscopic treatment of tibial intercondylar anterior cruciate fracture with wire strapping fixation is a easy and reliable operation, with no need for secondary arthroscopic surgery, which is a satisfactory treatment.