关节镜下可吸收线与钢丝内固定治疗胫骨髁间嵴骨折的对比分析

目的：比较可吸收线与钢丝两种内固定材料治疗胫骨髁间嵴骨折的临床效果。方法：2000年3月～2008年8月共完成36例手术,A组使用爱惜康编织可吸收0号线固定20例,B组使用钢丝固定16例。两组采用同一手术方法及术者,即在关节镜监视下行撕脱骨折块复位,利用前十字韧带胫骨导向器在骨床或骨块上准确确定钻孔位置,横穿前十字韧带基底并经骨床或骨块上的钻孔及骨隧道引出关节外打结、固定。结果：全部病例获得随访,随访时间为4～24个月,平均12个月;膝关节活动度正常者34例,2例Ⅲ型骨折关节屈曲活动〈90°。X线片示骨折全部愈合,两组复位情况及术后骨折愈合方面无明显差异,而A组在生物相容性、生物力学、关节功能及并发症等方面较B组优越,但A组平均手术时间较B组长7min。结论：关节镜监视下手术治疗胫骨髁间嵴撕脱骨折可最大程度地减少手术创伤,手术方法简便易行,使用爱惜康编织可吸收0号线固定较钢丝固定具有较多的优越性。

The comparative analysis of absorption lines and wire fixation for the treatment of tibia intercondylar eminence fracture under arthroscope

Objective：To compare the clinical effects of two kinds of absorption lines and wire fixation materials for the treatment of tibial intercondylar eminence fracture. Methods：Completed a total of 36 cases of surgery from March 2000 to August 2008. Group A used the Ethicon braided absorbable 0 line to fix 20 cases,group B used wire fixation in 16 cases. The two groups used the same surgical techniques and surgeon,that was downstream arthroscopy avulsion fracture block reduction,the use of anterior cruciate ligament tibial guide device in the bone or the bone bed to accurately determine the drilling location,across the basement and after anterior cruciate ligament bone bed or on the bone drilling and bone tunnel leads to extra-articular knot fixed. Results：All patients were followed up for 4-24 months,with an average of 12 months; knee to normal activity were 34 cases,2 cases of type Ⅲ fracture of joint flexion was less than 90°. X-ray films showed all fractures healed. There was no significant difference between the reset conditions and fracture healing. Group A was superior in biocompatibility,bio-mechanics,joint function and complications than group B,but the operative time of group A was longer with a mean of 7 minutes than group B. Conclusion：Treating tibial intercondylar eminence avulsion fractures under the supervision of arthroscope may minimize surgical trauma,surgical method is simple. The use of Ethicon braided absorbable 0 line to fix has more superiorities than the fixed wire.