膝关节镜下髁间棘撕脱骨折的手术治疗

目的 :探究膝关节镜下手术进行髁间棘撕脱骨折复位钢丝内固定治疗的一种新方法 ,介绍微创手术治疗的临床经验。方法 :1999年 4月至 2 0 0 1年 10月间在膝关节镜下手术治疗髁间棘撕脱骨折共 15例 ,其中应用钢丝进行骨折块内固定治疗髁间棘撕脱骨折 12例。手术方法 :膝关节镜监视下 ,应用镜下重建前交叉韧带的定位器确定骨折块的固定位点 ,经导向器钻骨道 ,利用钢丝内固定。术后早期进行康复。结果 :术后随访 6月～ 3年 ,平均 1年 11个月 ,X线片显示骨折复位与愈合良好 ;急性损伤 4例前向不稳均纠正 ,前抽屉试验及Lachman试验阴性 ;陈旧损伤 9例前向不稳纠正 ,其中 2例检查前抽屉及Lachman试验稍松 ,但患者主观稳定性良好。结论 :膝关节镜下手术治疗髁间棘撕脱骨折具有微创的特点。应用该手术方法治疗髁间棘撕脱骨折操作简捷、固定可靠、手术创伤小 ,术后可以早期进行功能康复。同时为关节镜下手术治疗髁间棘撕脱骨折提供了新的方法

Arthroscopically Assisted Surgical Treatment of Tibial Eminence Fractures

Objective To investigate the clinical importance of a newly designed arthroscopically assisted surgical treatment method for avulsion fracture of tibial eminence. Methods 15 cases of avulsion fracture of the tibial eminence involving the ACL were treated arthroscopically, 12 of the 15 cases were treated with steel wiring internal fixation. Assisted with ACL aimer, we located the site of fracture accurately and made bone tunnel for further steel wiring fixation under arthroscopy. Rehabilitation program started soon after operation. Results All patients were followed up for 6 to 36 months with average of 23 months. The clinical results were proved to be satisfied radiographically, demonstrating the reduction and union of the avulsed fragment in all cases. The stability of all knee joint was established with exception of 2 cases that were slightly slack in ADT and Lachman test. Conclusion Our clinical practice indicated that this newly designed micro-trauma surgical treatment can provide firm fixation and is easy to be operated. Moreover, early rehabilitation can be performed soon after operation.