后内侧小切口微创固定治疗成人胫骨髁间后棘骨折

目的评价后内侧小切口微创内固定治疗成人胫骨髁间后棘骨折的手术效果。方法 2010年3月至2016年3月,采用后内侧小切口空心螺钉内固定治疗成人胫骨髁间后棘骨折患者21例,男15例,女6例,年龄23~62岁,平均37.6岁。均为闭合性损伤。受伤至手术时间0.5~8天,平均3.5天。采用美国特种外科医院(HSS)膝关节评分系统评价临床疗效,影像学检查评价骨折愈合情况。结果 21例患者均获随访,时间13~52个月,平均21.5个月。X线证实骨折均一期愈合,无伤口感染及神经损伤并发症,无内固定失效,手术时间40~65分钟,平均48分钟,出血量30~100 m L,平均56 m L,术后HSS膝关节评分标准优17例,良3例,中1例,优良率95%。结论后内侧小切口微创固定成人胫骨髁间后棘骨折创伤小,暴露满意,出血少,手术时间短,术后膝关节功能恢复满意,是治疗成人胫骨髁间后棘骨折的理想方法。

Minimally invasive fixation of posterior intercondylar process fracture in adults with posteriorme-dial mini incision

Objective To evaluate the clinical effect of minimally invasive fixation of posterior intercondylar process fracture in adults with posteriormedial mini incision. Methods From March 2010 to March 2016, 21 adult patients with posterior intercondylar process fracture were treated by minimally invasive fixation with posteriormedial mini incision. There were 15 males and 6 females, with an average age of 37.6 years（range from 23 to 62 years）. All cases were closed fracture. The average time between injury and operation was 3.5 days （range from 0.5 to 8 days）. The clinical effects were assessed with HSS knee scores, and the fracture healing was assessed with images. Results The 21 patients were followed up for average 21.5 months（range from 13 to 52 months）. Fracture healings were successfully achieved in all cases, with no complications of infection, nerve injury and implant failure. The mean operation time was 48 minutes（range from 40 to 65 minutes）. The mean blood loss was 56 ml（range from 30 to 100 ml）. According to HSS knee scores, there were excellent in 17 cases, good in 3 cases, fair in 1 case. The overall excellent and good rate was 95%. Conclusion The technique that minimally invasive fixation of posterior intercondylar process fracture in adults with posteriormedial mini incision can accomplish less injury, satisfactory exposure, less blood loss and shorter operation time. The rehabil-itation is fast and it is an ideal technique to treat posterior intercondylar process fracture in adults.