关节镜下陈旧性胫骨髁间棘骨折的治疗

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1、关节镜下陈旧性胫骨髁间棘骨折的治疗【摘要】探究关节镜辅助下陈旧性胫骨髁间棘骨折的治疗。［方法］15例陈旧性胫骨髁间棘骨折患者，15个膝，分为两组。一组采用关节镜下钢丝固定；一组采用关节镜下胫骨髁间棘骨折清理并重建前交叉韧带。观察骨折愈合情况和膝关节稳定性并行Lysholm膝关节评分评价疗效。［结果］钢丝固定组有6例，胫骨髁间棘骨折清理并重建前交叉韧带组有9例，随访时间：10〜38个月。钢丝固定组有1例术后3个月发生固定钢丝断裂，其余5例均于术后6〜8周愈合，膝关节稳定性两组无差异。术后6个月Lysholm膝关节功能评分：钢丝固定组为土，胫骨髁间棘骨折清理并重建前交叉韧带组为土，两组

2、比较有统计学差异。［结论］陈旧性胫骨棘骨折多由新鲜骨折治疗不及时或治疗不当演变而来；对于III型以上的陈旧性胫骨髁间棘骨折或者受伤后时间较长的陈旧性胫骨髁间棘骨折患者，采用关节镜下胫骨髁间棘骨折清理并一期施行前交叉韧带重建手术，具有治疗时间短、膝关节功能恢复快、临床疗效好等优点。【关键词】胫骨髁间棘骨折陈旧性骨折关节镜治疗Abstract:［Objective］Toinvestigatethetreatmentofoldtibisunderarthroscopy.esinl5patientswithaleminencefractureMethod]Fifteenkneoldtibi

3、aleminencefreatedwitharthroscopicreductionandwiresfixation,theothergroupweretreatedarthroscopicanteriorcruciateligamentobservedthefracturehealingwithXray，measuredthestabi1ityofthekneesandevaluatedaccordingtoLysholmkneescoresystem.[Result]Sixpatientsinarthroscopicreductionandwiresfixationgroup(

4、threecasesoftypeII,threecasesoftypeIII)andninepatientsinarthroscopicanteriorcruciateligamentreconstructiongroup(twocasesoftypeII,fivecasesoftypeIIIandtwocasesoftypeIV)werefoIlowedupforl0to38ms).Onecaseinarthrowiresfixationgroupgeatthreemonthsaftbonehealingtimeintonths(mean18monthscopicreductio

5、nandwasfoundwirebreakaeroperation，heotherfivecasesweandthere68weeks.TherewerenodifferencesbetweentwogroupsinthestabilityoftheaverageLysholmkneescorewere土inarthroscopicreductionandwiresfixationgroupand±arthroscopicanterireconstructiongroustatisticallysigniorcruciateligamentpat6monthsafterwasfic

6、ancebetweentheteofmisdiagnosisoraamentreconstructiodtibialeminencefracturesorinoldtibialeminencefracturepatientswithlongtimwogroupsinLysholmkneescore.[Conclusion]TheoldfracturesaredevelopedfromfreshfracturesbecausnteriorcruciatelignintypeIIIandtypeIVolemaybeoneoftheexcellentcanreducehospitalst

7、ay，rehabilitation，andthemorbidityassociatedwiththeuseofanarthrotomyfortreatment.Keywords:Tibialeminencefracture；Oldfracture；Arthroscopy；TreatmentPringle在1907年首先描述了胫骨髁间棘骨折，由于运动伤和交通事故伤的不断增多，该类骨折的发生率呈不断增高的趋势，占整个前交叉韧带损伤的14%。腔骨髁间棘骨折多因外固定不当，治