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目的评价关节镜下线型固定青少年胫骨髁间隆起撕脱骨折的临床疗效。方法笔者选择自2014-09—2015-09初次关节镜下线型固定18例青少年胫骨髁间隆起撕脱骨折,观察其术后疗效。术后应用症状与体征量化评分标准、Lysholm评分评估其术后疗效。结果术后切口均一期愈合。术后18例获得随访平均6(3~9)个月。症状与体征量化评分标准评分结果:优14例,良2例,可1例,差1例,优良率88.9%。术后立即复查X线片示骨折断端复位良好,术后3个月再次复查均达到骨性愈合,未见创伤性关节炎表现。17例前抽屉试验(-)、Lachman试验(-),1例前抽屉试验(+-)、Lachman试验(-)。末次随访Lysholm评分为(93.8±3.7)分,与术前(45.2±6.4)分比较,差异有统计学意义(t=27.892,P<0.001);末次随访IKDC2000主观膝关节评分平均为(90.2±4.2)分,与术前(49.8±5.1)分比较,差异有统计学意义(t=25.943,P<0.001)。术后肢体功能恢复满意。结论对于青少年胫骨髁间隆起撕脱骨折的治疗,关节镜下线型内固定不仅能够有效复位骨折断端,而且固定效果确切,有利于早期膝关节功能的恢复,能够在短时间内最大程度恢复膝关节的稳定性。
Objective To evaluate the clinical efficacy of arthroscopic fixation of tibial intercondylar eminence avulsion fractures in adolescents. Methods The author chose from 2014-09-2015-09 initial arthroscopic linear fixation of 18 cases of adolescent tibial intercondylar eminence avulsion fracture and observed its postoperative efficacy. Postoperative symptoms and signs of quantitative evaluation criteria, Lysholm score to evaluate its efficacy. Results All incisions healed in one time. 18 cases were followed up for an average of 6 (3-9) months. Symptoms and signs of quantitative score standard score results: excellent in 14 cases, good in 2 cases, fair in 1 case, poor in 1 case, good rate of 88.9%. Immediately after the review X-ray showed fractured fracture resection well, again after 3 months of re-examination of bone healing were achieved, no traumatic arthritis. 17 cases of front drawer test (-), Lachman test (-), 1 front drawer test (+ -), Lachman test (-). The Lysholm score of the last follow-up was (93.8 ± 3.7) points, which was significantly different from that of preoperative (45.2 ± 6.4) points (t = 27.892, P <0.001) 4.2) points, compared with the preoperative (49.8 ± 5.1) points, the difference was statistically significant (t = 25.943, P <0.001). Postoperative recovery of limb function satisfaction. Conclusion Treatment of adolescent tibial intercondylar eminence avulsion fractures with arthroscopic linear internal fixation can not only effectively restore the fracture ends, but also have a definite effect of fixation, which is conducive to the recovery of early knee function and can recover maximally in a short period of time Knee stability.