关节镜下治疗胫骨髁间棘骨折.doc

天津港口医院 郭晓征
【摘要】  目的 探讨关节镜下复位并内固定治疗胫骨髁间棘骨折的手术方法及疗效。方法 对14例MeyersMckeever Ⅱ、Ⅲ、Ⅳ的胫骨髁间棘骨折患者施行关节镜下复位及内固定术。在关节镜监视下,对移位或翻转的粉碎骨折块进行复位,用不可吸收缝合线或自攻空心松质骨螺钉对骨折块行内固定,同时处理合并伤。术后使用支具于伸膝位制动4～6周,术后给予相应阶段的康复指导。结果 全部患者术后骨折愈合良好，伤膝关节活动度与健侧一致，关节稳定。结论 对于胫骨髁间棘骨折,根据患者年龄、骨折类型、选取适合的内固定方式，在关节镜监视下完全可以做到满意的骨折整复,可靠的内固定,重建前交叉韧带的稳定性。关节镜下复位、内固定手术创伤小，较膝关节开放手术具有明显优越性。
【关键词】  胫骨髁间棘;骨折;交叉韧带;膝关节;关节镜
Surgery treatment for tibial intercondylar eminence fracture under arthroscopy
　　XIE Jie,HUANG Zhang,PAN Liangchun,et al
　　(Department of Orthropedics,Third Affiliated Hospital of Anhui Medical University,First People's Hospital of Hefei,
　　Hefei 230061,China)
　　Abstract： Objective To evaluate the efficacy and operation techniques of the surgery treatment for tibial intercondylar eminence fracture under an arthroscopyMethods Totally 14 cases of tibial intercondylar eminence fractures underwent reduction and internal fixation under arthroscopy(MeyersMckeever Ⅱ，Ⅲ，Ⅳ)The fracture was reduced and fixed with nonabsorbable suture or cannulated screwsThe associated injury was treated at the same timeThe injured leg was fixed by brace on kneeextended position for 4～6 weeks after operationRehabilitation instructions were performed according to different stagesResults All fractures healedInjured joints were stabilized with normal motionConclusion The method of the internal fixation should be performed according to age,