摘要
目的探讨关节镜下规避骺板经单一隧道使用PDS-Ⅱ线结合Endobutton钢板固定治疗儿童胫骨髁间嵴骨折的临床疗效。方法回顾性分析11例胫骨髁间嵴骨折患儿的临床资料,均在关节镜下规避骺板经单一隧道使用PDS-Ⅱ线结合Endobutton钢板固定治疗。术后随访,观察骨折愈合情况及膝关节稳定性,记录膝关节Lysholm评分、功能独立性测评(FIM)量表评分、2000国际膝关节评分委员会(2000 IKDC)膝关节主观评分、疼痛视觉摸拟量表(VAS)评分,以及并发症的发生情况、膝关节功能恢复情况。结果11例患者术后随访时间为6~12个月,平均9.4个月。(1)术后第1天复查患膝X线片提示胫骨髁间嵴撕脱骨块复位满意,各切口均于2周内甲级愈合并拆线。所有患者骨折均于术后3个月骨性愈合,未发现骨折畸形愈合、肢体不等长、伤肢出现内外翻畸形等情况,膝关节活动度正常,前抽屉试验及Lachman试验阴性,膝关节稳定性良好。(2)术前、术后2周、术后3个月、末次复诊时患儿的膝关节Lysholm评分、2000 IKDC评分、FIM量表评分均依次升高,疼痛VAS评分依次降低;末次复诊时膝关节Lysholm评分基本恢复伤前水平,2000 IKDC膝关节主观评分基本达满分,大部分患者处于无痛状态。(3)术后6个月,患者膝关节优良率为100.00%。所有患者术后均未出现双下肢长度不一致、双膝关节外翻角度不一致、切口感染、内固定物移位等并发症。结论关节镜下规避骺板经单一隧道使用PDS-Ⅱ线结合Endobutton钢板固定治疗儿童胫骨髁间嵴骨折是一种微创、可靠的治疗方式,其操作简单,固定可靠,治疗效果好,同时可以避免损伤骺板等相关并发症。
Objective To investigate the clinical efficacy of arthroscopic treatment of children's tibial intercondylar crest fracture by using PDS-Ⅱline combined with Endobutton steel plate fixation through a single tunnel with evasive epiphyseal plate.Methods The clinical data of 11 children with tibial intercondylar crest fracture were analyzed retrospectively.All of the children underwent arthroscopic treatment by using PDS-Ⅱline combined with Endobutton steel plate through a single tunnel with evasive epiphyseal plate.Postoperative follow-up was conducted to observe the fracture healing and the stability of knee joint,and to record the Lysholm score of knee joint,the score of Functional Independence Measure(FIM),the subjective score of knee joint of 2000 International Knee Documentation Committee(2000 IKDC),the pain Visual Analogue Scale(VAS)score,the occurrence of complications and the recovery of knee joint function.Results Eleven patients were followed up for 6 to 12 months,with an average of 9.4 months.(1)On the first day after operation,the X-ray reexamination of the injured knee showed that the avulsion bone of tibial intercondylar crest was restored satisfactorily,and all the incisions were healed and sutured within 2 weeks.All patients had bone healing at 3 months after operation,without fracture malunion,limb length discrepancy,varus or valgus deformity of the injured limb.The knee joint activity was normal,the anterior drawer test and Lachman test were negative,and the knee joint stability was good.(2)The Lysholm score,2000 IKDC score and FIM scale score increased and the pain VAS score decreased successively before operation,2 weeks after operation,3 months after operation and the last follow-up.At the last follow-up,the Lysholm score of knee joint basically recovered to the pre-injury level,the 2000 IKDC subjective knee score basically reached full score,and most patients were in a painless state.(3)At 6 months after operation,the excellent and good rate of knee joint was 100.00%.All patients had no postoperative complications such as inconsistent length of lower limbs,inconsistent valgus angle of bilateral knee joints,incision infection,and internal fixation displacement.Conclusion Arthroscopic treatment of children's tibial intercondylar crest fracture by using PDS-Ⅱline combined with Endobutton steel plate through a single tunnel with evasive epiphyseal plate is a minimally invasive and reliable treatment method,which is simple in operation,reliable in fixation,good in treatment effect,and can avoid epiphyseal plate injury and other related complications.
作者
彭伟
盛希
王胜涛
陈东旭
陈明洲
李朝旭
PENG Wei;SHENG Xi;WANG Shengtao;CHEN Dongxu;CHEN Mingzhou;Li Zhaoxu(Department of Joint Surgery and Sports Medicine,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,Guangxi,China)
出处
《微创医学》
2024年第1期27-32,共6页
Journal of Minimally Invasive Medicine
基金
桂林市自筹经费科技项目(编号:20210105z)
广西医疗卫生重点(培育)学科建设项目(编号:桂卫科教发〔2022〕4号)。
