摘要
目的比较膝关节镜下中央部切除加外周缝合技术与关节镜下盘状半月板次全切两种不同的手术方法治疗儿童外侧盘状半月板(discoid lateral meniscus,DLM)损伤的临床疗效。方法回顾性分析浙江大学金华医院(金华市中心医院)骨一科2010年10月至2014年12月收治的有症状的DLM学龄期患儿(7~14岁,平均10岁)60例的临床资料。按手术方式将患儿分成两组。A组30例,采用膝关节镜下中央部切除加外周缝合技术,B组30例,采用关节镜下盘状半月板次全切除术,分别对两组病例的症状、并发症、手术时间、切口总长度及术后1年对手术前后采用Lysholm评分进行膝关节功能评定,并进行比较。评价不同手术方式对儿童症状性DLM的临床疗效。结果所有患儿均获随访,随访时间12~24个月,平均18个月,症状都明显缓解,无并发症。A组与B组手术切口长度分别为(2.0±1.1)cm和(1.5±0.9)cm,手术时间分别为(60.0±20.4)min和(40.0±20.8)min。组间差异均具有统计学意义(P<0.05)。A组与B组患儿术前与术后Lysholm评分较术前均有显著提高,差异均具有统计学意义(P<0.05),两组间术后1年Lysholm评分差异无统计学意义(P>0.05)。结论术后两组患儿的症状较术前均得到有效缓解,在儿童症状性DLM患儿中,都是安全、有效的方法。但关节镜下DLM次全切,与关节镜下中央部切除加外周缝合技术比较,具有切口小、手术时间短的优点。
Objective To compare the surgical outcomes of discoid lateral meniscal tearing by arthroscopic central meniscectomy with peripheral suturing and subtotal meniscectomy in children. Methods Retrospective reviews were conducted for 60 consecutive arthroscopic cases from 2010 to 2014. Arthroscopic central meniscectomy with peripheral suture repair (group A, n=30) and subtotal meniscectomy (group B, n=30) were performed. The median age was 10(7-14) years. Symptoms, complications, length of incision, operative duration and preoperative & postoperative 1-year Lysholm scores were compared. Results The average follow-up period was 18(12-24) months. At the final follow-up, all of them stayed pain-free and could resume full activities without any complication. The incision length of two groups was (2.0±1.1) and (1.5±0.9) cm and the operative duration (60.0±20.4) and (40.0±20.8) min respectively. The inter-group differences were statistically significant (P<0.05). In both groups, Lysholm scores significantly increased postoperatively and the differences had statistical significance (P<0.05) while postoperative 1-year Lysholm score showed no inter-group differences of statistical significance (P>0.05). Conclusions The symptoms of two groups are relieved significantly after effective procedures in children with symptomatic discoid lateral meniscus. However, as compared with arthroscopic central meniscectomy with peripheral suturing, subtotal meniscectomy offers the advantages of smaller incision and shorter operative duration.
作者
周勇伟
李晓飞
杨骐宁
曹扬
高思琪
Zhou Yongwei;Li Xiaofei;Yang Qining;Cao Yang;Gao Siqi(Department of Orthopedics, Municipal Central Hospital, Zhejiang University, Jinhua 321000, China)
出处
《中华小儿外科杂志》
CSCD
北大核心
2019年第10期935-938,共4页
Chinese Journal of Pediatric Surgery
