摘要
目的探讨关节镜下胫骨骨道联合双排锚钉固定治疗胫骨髁间棘骨折的疗效。方法回顾性分析2015年10月至2019年12月期间就诊于北京市顺义区医院骨科并接受关节镜辅助下胫骨骨道联合双排锚钉固定手术治疗的23例胫骨髁间棘骨折患者的临床资料。男15例,女8例;平均年龄35.5岁(12~55岁);均为单侧损伤(右侧14例,左侧9例)。胫骨髁间棘骨折根据改良Meyers-Mckeever分型标准:Ⅱ型2例,Ⅲ型18例,Ⅳ型3例。收集并比较术前与术后1个月、12个月患者的膝关节活动度、Lysholm评分和国际膝关节文献委员会膝关节评估表(IKDC)评分;测量患者术前及术后1个月时CT的胫骨前坡角(ATSA)并评估骨折复位情况。结果23例患者术后获平均23个月(12~52个月)随访。术后2例患者存在膝关节活动受限,1例患者骨折未达到解剖复位。患者术后1、12个月的Lysholm评分[(61.4±3.5)、(90.4±4.3)分]、IKDC评分[(69.6±4.2)、(88.5±3.0)分]均较术前[(45.4±6.8)、(49.6±3.9)分]显著改善,差异有统计学意义(P<0.05)。ATSA由术前的4.2°±5.7°恢复到术后1个月的-11.7°±2.9°,差异有统计学意义(P<0.05)。结论关节镜下胫骨骨道联合双排锚钉固定手术治疗胫骨髁间棘骨折可以达到解剖复位和牢固固定,可获得满意的手术疗效。
Objective To evaluate arthroscopy-assisted tibial bone tunnel fixation combined with double-row anchors in the treatment of tibial eminence fracture.Methods The 23 patients were retrospectively analyzed who had been treated at Department of Orthopedics,Beiing Shunyi District Hospital for tibial eminence fractures by arthroscopy-assisted tibial bone tunnel fixation combined with double-row anchors from October 2015 to December 2019.They were 15 males and 8 females,aged from 12 to 55 years(average,35.5 years).All the injuries were unilateral(14 right and 9 left sides).According to the modified Meyers-McKeever classification,2 cases belonged to typeⅡ,18 cases to typeⅢand 3 cases to typeⅣ.Range of motion of the knee,Lysholm and International Knee Documentation Committee(IKDC)scores were observed before surgery,1 month and 12 months after surgery.The anterior tibial slope angle(ATSA)on CT was measured preoperatively and 1 month after surgery for evaluation of fracture reduction.Results All the 23 patients were followed up for an average of 23 months(from 12 to 52 months).Postoperatively,limited knee movement was observed in 2 patients and non-anatomic reduction in one patient.At 1 month and 12 months after operation,the Lysholm scores(61.4±3.5 and 90.4±4.3)and IKDC scores(69.6±4.2 and 88.5±3.0)were significantly improved compared with the preoperative values(45.4±6.8 and 49.6±3.9,respectively)(P<0.05).ATSA was significantly restored from preoperative 4.2°±5.7°to-11.7°±2.9°at 1 month after operation(P<0.05).Conclusion In the treatment of tibial eminence fracture,arthroscopy-assisted tibial bone tunnel fixation combined with double-row anchors can achieve anatomical reduction and firm fixation,leading to satisfactory surgical outcomes.
作者
杨成刚
范宁
陈晓鹏
王金伟
赵卿
Yang Chenggang;Fan Ning;Chen Xiaopeng;Wang Jinwei;Zhao Qing(Department of Orthopedics,Beiing Shunyi District Hospital,Beiing 101300,China;Department of Orthopedics,Beiing Chaoyang Hospital,Capital Medical University,Beiing 100043,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2021年第5期448-452,共5页
Chinese Journal of Orthopaedic Trauma
