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目的探究膝关节镜引导下微创小切口复位使用掌指骨螺钉内固定治疗青少年股骨髁骨软骨骨折的临床疗效。方法选择2014年1月-2015年10月新疆医科大学第六附属医院关节外科收治的青少年股骨髁骨软骨骨折的患者103例,分析接受关节镜引导下微创小切口复位掌指骨螺钉内固定治疗的临床疗效,其中男性48例,女性55例,年龄10~17岁(平均14.7岁),内侧髁30例,外侧髁73例。术前Lysholm评分(41.90±4.94)分,IKDC评分(32.20±4.01)分。比较手术前、后影像学变化,且分别于术后3、6个月进行随访,末次随访时采用Lysholm评分和IKDC评分评估术后患者膝关节功能恢复情况。结果术后3个月,Lysholm评分为(82.90±1.87)分,术后较术前评分显著提高,差异有统计学意义(t=-42.58,P<0.001);IKDC评分为(66.50±3.17)分,术后较术前评分显著提高,差异有统计学意义(t=-36.7,P<0.001)。结论膝关节镜引导下微创小切口复位后使用掌指骨螺钉内固定是治疗股骨髁骨软骨骨折的有效方法,其具有创伤小、术后功能恢复快的优点,值得在临床上推广。
Objective To investigate the clinical effect of minimally invasive minimally invasive reduction guided by knee arthroscope in the treatment of adolescent femoral condylar osteochondral fracture using metacarpal and phalangeal screw fixation. Methods 103 cases of adolescent femoral condylar osteochondral fractures admitted to the Department of Joint Surgery, the Sixth Affiliated Hospital of Xinjiang Medical University from January 2014 to October 2015 were retrospectively analyzed. The patients underwent arthroscopic minimally invasive reduction with metacarpal and phalangeal screw fixation The clinical efficacy, including 48 males and 55 females, aged 10 to 17 years (mean 14.7 years), medial condyle in 30 cases, lateral condyle in 73 cases. Preoperative Lysholm score (41.90 ± 4.94) points, IKDC score (32.20 ± 4.01) points. The changes of imaging before and after surgery were compared. The patients were followed up for 3 and 6 months respectively. At the last follow-up, the Lysholm score and IKDC score were used to evaluate the postoperative recovery of knee joint function. Results The Lysholm score was (82.90 ± 1.87) at 3 months after operation. The postoperative score was significantly higher than that before operation (t = -42.58, P <0.001). The IKDC score was (66.50 ± 3.17) Points, postoperative significantly higher than the preoperative score, the difference was statistically significant (t = -36.7, P <0.001). Conclusions The minimally invasive mini-incision guided by knee arthroscopy is an effective method for the treatment of osteochondral fractures of the femoral condyle after reduction with metacarpal and phalangeal screws. It has the advantages of less trauma and quick recovery after operation, and is worthy of clinical promotion.