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关节镜下克氏针结合缝线不经骨骺线固定治疗儿童胫骨髁间隆突骨折
Hits: 1907   Download times: 1684   Received:October 17, 2014    
作者Author单位UnitE-Mail
赵其纯 ZHAO Qi-chun 安徽省立医院骨科, 安徽 合肥 230001 Department of Orthopaedics, Captial Hospital of Anhui, Hefei 230001, Anhui, China qichzhao@163.com 
邓小文 DENG Xiao-wen 安徽省立医院骨科, 安徽 合肥 230001 Department of Orthopaedics, Captial Hospital of Anhui, Hefei 230001, Anhui, China  
周平 ZHOU Ping 安徽省立医院骨科, 安徽 合肥 230001 Department of Orthopaedics, Captial Hospital of Anhui, Hefei 230001, Anhui, China  
尚希福 SHANG Xi-fu 安徽省立医院骨科, 安徽 合肥 230001 Department of Orthopaedics, Captial Hospital of Anhui, Hefei 230001, Anhui, China  
朱亚林 ZHU Ya-lin 安徽省立医院骨科, 安徽 合肥 230001 Department of Orthopaedics, Captial Hospital of Anhui, Hefei 230001, Anhui, China  
期刊信息:《中国骨伤》2015年28卷,第6期,第504-507页
DOI:10.3969/j.issn.1003-0034.2015.06.005


目的:探讨膝关节镜下单枚克氏针加缝线不经过骨骺线固定治疗儿童胫骨髁间隆突骨折的技术及临床应用效果。

方法:自2008年5月至2012年12月治疗21例儿童胫骨髁间隆突骨折, 年龄6~14岁, 男13例, 女8例。根据Meyers-McKeever骨折分型:Ⅱ型7例, Ⅲ型10例, Ⅳ型4例。手术均采用关节镜下复位, 单枚克氏针加缝线不经过骨骺线固定。术后1周积极开始功能锻炼, 并随访10~30个月, 术后1、3、6个月摄X线片观察骨折愈合情况, 记录关节活动度、前抽屉试验、Lachman试验、关节功能Lysholm评分, 评价临床效果。

结果:术后6周, 21例胫骨髁间隆突骨折均愈合, 无骨折移位。术后3个月, 前抽屉试验、Lachman试验均阴性。术后6个月, Lysholm膝关节功能评分93.3±5.2,复查X线片未见骨骺线增宽或变窄。

结论:关节镜下单枚克氏针加"8"字缝线不经过骨骺线固定治疗儿童胫骨髁间隆突骨折, 复位和固定可靠, 不经过骨骺线, 手术创伤小, 对骨骺干扰小, 能够早期关节功能锻炼, 疗效满意。
[关键词]:胫骨骨折  关节镜  骨折固定术  儿童
 
Arthroscopic treatment of tibial intercondylar eminence fractures in children with single Kirschner wire and suture avoiding epiphyseal line fixation technique
Abstract:

Objective:To discuss arthroscopic technique of single Kirschner wire and suture avoiding epiphyseal line fixation for tibial intercondylar eminence fracture and its clinical results.

Methods:From May 2008 to December 2012, 21 patients (13 males, 8 females, ranging in age from 6 to 14 years old) with tibial intercondylar eminence fracture were treated arthroscopically with single Kirschner wire and suture avoiding epiphyseal line fixation technique. According to Meyers and McKeever classification, 7 patients were typeⅡ, 10 patients were typeⅢ, and 4 patients were type Ⅳ。 Active rehabilitation began at one week after operation. The patients were followed up for 10 to 30 months. X-ray films were taken to evaluate fracture healing at 1, 3, 6 months after operation; range of motion, the anterior drawer test, the lachman test and the Lysholm knee score were used to evaluate clinical effects.

Results:All fractures were healed without displacement at 6 weeks after operation. Anterior drawer test and the lachman test were both negative in all patients at 3 months after operation. Lysholm knee score was 95.5±2.5 at 6 months after operation, and postoperative X-ray film did not find epiphyseal line broadening or narrowing.

Conclusion:Arthroscopic treatment for tibial eminence intercondylar fracture with single Kirschner wire and 8-shaped suture avoiding epiphyseal line fixation technique has many advantages, such as firm fixation, early mobilization, less invasive, less injury of physis and satisfactory effect.
KEYWORDS:Tibial fracture  Arthroscopic  Fracture fixation  Children
 
引用本文,请按以下格式著录参考文献:
中文格式:赵其纯,邓小文,周平,尚希福,朱亚林.关节镜下克氏针结合缝线不经骨骺线固定治疗儿童胫骨髁间隆突骨折[J].中国骨伤,2015,28(6):504~507
英文格式:ZHAO Qi-chun,DENG Xiao-wen,ZHOU Ping,SHANG Xi-fu,ZHU Ya-lin.Arthroscopic treatment of tibial intercondylar eminence fractures in children with single Kirschner wire and suture avoiding epiphyseal line fixation technique[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(6):504~507
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