关节镜手术治疗胫骨髁间隆突撕脱性骨折

摘要

Objective:To evaluate the efficacy and operation techniques of the reduction and internal fixation under arthroscopy in the treatment of avulsion fracture of tibia intercondylar eminence. Methods:Sixty-six cases with types Ⅱ,Ⅲ,Ⅳof Meyers-McKeever avulsion fracture of tibia intercondylar eminence were treated with reduction and internal fixation under arthroscopy, which included 9 cases treated with steel wire internal fixation and 7 cases treated with hollow screw. The adjustable supports were used to fix the injury leg on knee-extended position for 4 to 5 weeks at postoperative 3 weeks,the corresponding functional exercise guidance was implemented after operation. Results:All fractures healed by X-ray detection,the knee joint mobility arrived at normal and the Lachman test and front drawer test were negative at 3 months after operation. The complications such as the infection, stiffness, limitation of extension and flexion movement of joint,walking instability,and chronic pain in 16 cases were not found. Conclusions:The effects of the stainless steel wire and screw fixation techniques in the treatment of typesⅡ,Ⅲ,Ⅳof Meyers-McKeever fracture of tibia intercondylar eminence are good.%目的：探讨关节镜下复位内固定治疗胫骨髁间隆突撕脱骨折的手术方法及疗效。方法：对16例Meyers-McKeever Ⅱ、Ⅲ、Ⅳ型胫骨髁间隆突撕脱骨折患者施行关节镜下复位内固术,其中钢丝内固术9例,空心螺钉7例。术后3周使用可调式支具于伸膝位制动4~5周,术后给予相应功能锻炼指导。结果：16例患者术后骨折均愈合。术后3个月X线片显示骨折愈合,所有患者膝关节活动度正常,Lachman试验和前抽屉试验阴性。16例均未出现关节感染僵硬、屈伸受限、行走不稳和慢性疼痛等并发症。结论：关节镜下分别采用钢丝和空心螺钉对Meyers-McKeever Ⅱ、Ⅲ、Ⅳ型的胫骨髁间棘骨折固定均能获得较好疗效。