关节镜下双隧道缝线固定成人胫骨髁间前隆突骨折.docVIP

关节镜下双隧道缝线固定成人胫骨髁间前隆突骨折 　　[摘 要] 目的：探讨关节镜下双隧道缝线固定成人胫骨髁间前隆突骨折临床疗效。方法：自2012年10月至2014年8月，选取我院8例胫骨髁间前隆突骨折患者，按照Meyers-Mckeever分型，II型1例，III型5例，IV型2例，在关节镜下复位，使用不可吸收缝线经双骨隧道对骨折块进行内固定。术后患肢铰链支具固定6周，并指导患肢功能锻炼。结果：经过6～12个月随访，所有患者骨折均骨性愈合，无关节不稳，术后6个月膝关节HSS功能评分优6例，良1例，中1例，差0例，优良率93.3%，平均关节活动度125°（114°～140°）。结论：关节镜下双隧道缝线固定成人胫骨髁间前隆突骨折具有创伤小、操作简便及固定牢靠等优点，并能重建膝关节稳定性，恢复关节良好功能。 　　[关键词] 关节镜；双隧道；缝线；胫骨髁间前隆突骨折 　　中图分类号：R 683.42 文献标识码： A 文章编号：2095-5200（2015）04-038-03 　　[Abstract] Objective： To evaluate the efficacy of treatment for adult tibial intercondylar eminence fracture with suture by twin bore tunnel under an arthroscopy. Methods： From October 2010 to August 2014.8 patients underwent adult tibial intercondylar eminence fracture had been chosen as research object. Of 30 patients， 5 males， 3 females， averaged 35.12 years； according to the Meyers-Mckeever parting，1 for typeⅡ，5 for type Ⅲ and 2for type Ⅳ.Totally 8 cases of tibial intercondylar eminence fractures were reduced and fixed with non-Absorbable suture by twin bore tunnel. The associated meniscus injury was treated at the same time. The injured leg was fixed by brace on knee-extended position for 6 weeks after operation. Rehabilitation instructions were performed. Results： All fractures healed without instability. According to creiteria of HSS ， excellent were in 6 cases ，good in 1cases ，fair in 1 case and poor in 0 case with the rate of being excellent and good added up to 90%， average range of motion for 125°（114-140°）. Conclusion： Suture assisted management by twin bore tunnel in adult tibial intercondylar eminence fracture can help to reduce invasion ，operate simply ，fixed firmly， and rebuild stability， recover the function of joint. 　　[Key words] arthroscopy； twin bore tunnel； suture； tibial intercondylar eminence fracture 　　胫骨髁间前隆突骨折是常见膝关节内骨折，因解剖位置系前交叉韧带胫骨止点，治疗不当将可能导致膝关节不稳，伸膝活动受限，影响日后关节功能。临床上对胫骨髁间前隆突骨折常采用Meyers-Mckeever分型：Ⅰ型，撕脱骨块未分离，即只有前缘轻微翘起；Ⅱ型，撕脱骨块前部翘起较多，自平台分离抬起，在侧位可见前缘有一“鸟嘴样”畸形；Ⅲ型，撕脱骨块完全自平台分离呈游离状；Ⅳ型，撕脱骨块移位并粉碎者。目前普遍认为