胫骨髁间隆起撕脱骨折的手术治疗

自１９７５～１９９５年，作者采用切开复位，钢丝内固定治疗了胫骨髁间隆起撕脱骨折以及合并胫侧副韧带等损伤３１例，其中单纯胫骨髁间隆起撕脱骨折２４例；合并胫侧副韧带或内外侧半月板损伤者７例。术中骨折均达到解剖复位。术后骨折愈合良好，检查抽屉试验转阴率为８９％。膝关节功能恢复满意，优良率为８９．６％，而同期非手术治疗者优良率仅为７９．２％。作者认为：膝关节稳定性和功能的恢复，与骨折块良好复位及周围软组织损伤的修复有关。单纯保守治疗，骨折块移位愈合，交叉韧带处于松弛状态，可引起膝关节不稳定和继发性损害。采用手术治疗则能满足骨折复位和膝关节功能恢复的需要。因此，对该类型骨折宜早期手术治疗为好。

OperativeTreatmentofAvulsionFractureoftheIntercondylarEminenceofthe

Thirty-onecasesofavulsionfractureoftheintercondylareminenceofthetibiaweretreatedwithopenreductionandwirefixationbetween1975and1995.Ofthem,24wereisolatedavul-sionfracturesandtheremaining7wereassociatedwiththeinjuriesofthetibialcolateralligamentormeniscus.Anatomicalreductionwereachievedinal,andthefractureshadgoodunionatrecentfolow-ing-up.Thepositivedrawertestwereimprovedtonegativein89%ofthecases.Thesatisfactoryratewerereachedto89.6%,comparedwiththatof79.2?hievedbynon-operativegroup.Theauthorsconsideredthatthestabilityandfunctionalrecoveryofthekneecloselycorrelatedwithreductionandre-pairingofthesofttissuessuroundingtheknee.Conservativemethodwassubjectedtomalunionofthefractureandlooseningofthecruciateligament,whichmayleadtounstabilityofthekneejointandde-generativechanges.Operativemethodmaymeettherequirementforreductionandfunctionalrecovery.Therefore,theearlyoperativetreatmentmaybethebetterchoiceforthiscondition.