镜下改良双“8”字缝线固定II型胫骨棘撕脱骨折
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山东省威海市威海卫人民医院

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Fixed type II tibial spine avulsion fracture with modified double "8" suture under arthroscopy
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威海卫人民医院

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    摘要:

    [目的] 探讨关节镜下改良双“8”字双隧道治疗Meyers-MckeeverⅡ型胫骨髁间嵴骨折的临床疗效。[方法] 回顾性分析2015年10月—2020年5月应用关节镜下改良双“8”字双隧道治疗Meyers-MckeeverⅡ型胫骨髁间嵴骨折17例,男13例,女4例;年龄14~49岁,平均年龄(29.59±8.34)岁;均为单侧损伤(右侧12例,左侧5例)。总结17例患者术前、术后3个月、术后1年的膝关节伸屈ROM、VAS评分、Lyshol评分和IKDC评分评估患者膝关节功能恢复情况;检查前抽屉试验、Lachman试验、轴移试验评估患者膝关节稳定性。[结果] 17例患者随访9~36个月,平均随访时间(18.53±6.90)个月;手术时间40~49min,平均手术时间(45.94±2.93)min;均在术后10~12周内达到骨性愈合,平均骨折愈合时间(11.24±0.75)周;术后3个月、1年的膝关节伸屈ROM、VAS评分、Lyshol评分和IKDC评分分别为 [(102.18±3.76)、(124.06±0.97)°]、 [(2.29±0.47)、(0.94±0.66)分] 、 [(81.29±1.40)、(91.24±2.02)分] 、 [(79.65±2.80)、(89.47±2.37)分]均较术前 (67.59±1.12)°、(6.76±0.75)分 、(51.88±4.21)分、(53.35±2.89)分显著改善,差异有统计学意义(P<0.05)。前抽屉试验、Lachman试验及轴移试验均由术前阳性转为阴性。[结论] 关节镜下改良双“8”字双隧道治疗Meyers-MckeeverⅡ型胫骨髁间嵴骨折可以达到解剖复位和牢固固定,手术疗效满意。

    Abstract:

    [Objective] To investigate the clinical effect of modified double "8" double tunnel on Meyers-Mckeever type Ⅱ intercondylar ridge fracture of tibia under arthroscope.[Methods] 17 cases of Meyers-Mckeever type Ⅱ intercondylar ridge fracture of tibia were retrospectively analyzed from October 2015 to May 2020 by modified double "8" double-tunnel under arthroscope, including 13 males and 4 females. The average age was (29.59±8.34) years, ranging from 14 to 49 years. All lesions were unilateral (12 on the right side and 5 on the left side). The knee extension ROM, VAS score, Lyshol score and IKDC score of 17 patients were evaluated before surgery, 3 months after surgery and 1 year after surgery. The anterior drawer test, Lachman test, and axial shift test were examined to assess knee stability. [Results] 17 patients were followed up for 9 to 36 months, the mean follow-up time was (18.53±6.90) months. The average operation time was (45.94±2.93) min. Bone union was achieved within 10-12 weeks after surgery, and the mean healing time of fracture was (11.24±0.75) weeks. The ROM score, VAS score, Lyshol score and IKDC score at 3 months and 1 year after surgery were [(102.18±3.76), (124.06±0.97) °], [(2.29±0.47), (0.94±0.66)], respectively. [(81.29±1.40), (91.24±2.02) points], [(79.65±2.80), (89.47±2.37) points] compared with preoperative (67.59±1.12), (6.76±0.75) points , (51.88±4.21), (53.35±2.89), the difference was statistically significant (P < 0.05). The front drawer test, Lachman test and axial shift test all changed from positive to negative before operation. [Conclusion] The modified double "8" double tunnel under arthroscope for Meyes-McKeever type Ⅱ tibial intercondylar ridge fracture can achieve anatomical reduction and solid fixation, and the operative effect is satisfactory.

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  • 收稿日期:2023-06-15
  • 最后修改日期:2023-07-26
  • 录用日期:2024-01-19
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