摘要
目的探讨关节镜下钢丝固定治疗Ⅱ、Ⅲ型儿童胫骨髁问隆突撕脱性骨折的疗效及其影响因素。方法手法复位失败的Ⅱ、Ⅲ型胫骨髁间隆突撕脱性骨折患儿12例，行关节镜下复位、钢丝内固定治疗。平均随访时间24．4个月（12-32个月），Lachman试验、轴移试验评价膝关节稳定性，Lysholm评分及Tegner分级评价膝关节功能，术后X线评价骨折愈合情况。结果12例骨折均获得满意的复位，术后3个月内骨性愈合，X线检查未见骺板早闭现象。未见关节纤维化内固定松动感染等严重并发症发生。Lysholm膝关节功能评分96．7±2．2分，Tegner评分术前术后分别为2．8±1．1和7．5±0．9。结论关节镜下钢丝固定是治疗Ⅱ、Ⅲ型儿童胫骨髁问隆突撕脱性骨折的有效方法，可有效重建膝关节的稳定，改善膝关节功能。
Objective To investigate the therapeutic effect of arthroscopic reduction and internal fixation for children with type Ⅱ and Ⅲ tibial intercondylar eminence fractures. Methods Twelve cases with type Ⅱ and Ⅲ tibial intercondylar eminence fractures were treated with arthroscopie reduction and internal fixation. The average follow-up period was 24. 4 months ranging from 12 to 32 months. Follow-up assessment included Lachman test, pivot shift test, Lysholm knee score, Tegner score and radiological evaluation. Results All 12 cases successfully achieved reduction and bone union within 3 months without premature closure of epiphysis. No severe complications, such as arthrofibrosis, loss of initial fixation or wound infection, were noted. The pivot shift test and Lachman test showed that the stability of knees was recovered in all cases. At follow up, the average Lysholm knee score was 96. 7 ± 2.2. The preoperative and postoperative Tegner scores were 2. 8 ± 1.1 ranging from l to 5 and 7. 5 ± 0. 9 ranging from 6 to 9 respectively. Conclusions Arthroscopic reduction and internal fixation is an effective method for the treatment of type II and III tibial intercondylar eminence fractures in children, which can significantly improve the stability and joint functions of knees.
出处
《中华小儿外科杂志》
CSCD
北大核心
2009年第9期612-614,共3页
Chinese Journal of Pediatric Surgery
关键词
胫骨骨折
关节镜
Tibia fractures
Arthroscopes
