摘要
目的 探讨关节镜下复位内固定治疗骨骺未闭青少年前交叉韧带（anterior cruciate ligament,ACL）撕脱骨折疗效。方法 2011年1月-2013年10月,收治35例单膝ACL撕脱骨折的骨骺未闭青少年患者,均于关节镜下复位内固定治疗。男25例,女10例;年龄8～16岁,平均14.7岁。致伤原因：运动伤24例,交通事故伤9例,日常生活损伤2例。根据Meyers-McKeever分型标准：Ⅱ型27例,Ⅲ型8例。合并半月板损伤5例。术前国际膝关节文献委员会（IKDC）评分为（48.7±3.2）分,Lysholm评分为（51.2±4.5）分。患者受伤至手术时间为2～16 d,平均5 d。结果 术后切口均Ⅰ期愈合。患者均获随访,随访时间12～32个月,平均22.4个月。28例骨折解剖复位,7例接近解剖复位;末次随访时X线片复查示骨折均愈合。患肢无短缩畸形、双下肢不等长以及膝关节内、外翻畸形发生。Lachman试验均为阴性。术后6周1例膝关节屈曲受限,经对症处理后膝关节活动度恢复至0～120°;其余患者膝关节活动度均正常。末次随访时,IKDC评分及Lysholm评分分别为（93.2±4.1）、（96.2±2.5）分,均较术前显著提高,差异有统计学意义（t=—53.442,P=0.000;t=—56.242,P=0.000）。结论 对于骨骺未闭青少年ACL撕脱骨折患者,关节镜辅助下复位内固定创伤小、恢复快,近期疗效满意。
Objective To evaluate the clinical results of arthroscopic treatment of anterior cruciate ligament （ACL） tibial eminence avulsion fractures in adolescents with epiphyseal unclosure. Methods Between January 2011 and October 2013, 35 knees with ACL tibial eminence avulsion fractures （35 patients with epiphyseal unclosure） were arthroscopically treated with suture fixation. There were 25 males and 10 females, aged 8-16 years （mean, 14.7 years）. The causes included sports injury in 24 cases, traffic accident injury in 9 cases, and daily life injury in 2 cases. According to Meyers-McKeever classification criteria, there were 27 cases of type II and 8 cases of type III. Five cases had meniscus injury. The preoperative the International Knee Documentation Committee （IKDC） score was 48.7±3.2, and Lysholm score was 51.2±4.5. The time from in）ury to operation was 2-16 days （mean, 5 days）. Results Primary healing of incision was obtained in all patients. The mean follow-up time was 22.4 months （range, 12-32 months）. Anatomical reduction was achieved in 28 cases and satisfactory reduction in 7 cases. X-ray films showed all fractures healing at last follow-up. There was no limb shortening deformity, varus knee, or valgus knee. Lachman test results were all negative. The other knees had normal range of motion except I knee with limited flexion, whose range of motion returned to 0-120~ after treatment. At last follow-up, the IKDC score was significantly improved to 93.2_＋4.1 （t= -53.442, P=0.000）, and the Lysholm score was significantly increased to 96.2±2.5 （t= -56.242, P=0.000）. Conclusion The arthroscopic fixation technique has satisfactory results for the reduction and fLxation of ACL tibial eminence avulsion fracture in the adolescents with epiphyseal unclosure because of little trauma and auick recovery.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2015年第6期725-729,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
关节镜
前交叉韧带
撕脱骨折
青少年
Arthroscopy
Anterior cruciate ligament
Avulsion fracture
Adolescents
