【摘要】 目的 探讨关节镜下尼龙编织缝线固定胫骨髁间棘撕脱骨折的方法及疗效。方法 24例患者均经关节镜辅助下行骨折复位，借助于前交叉韧带定位器于胫骨结节内侧做4个骨隧道，2条Ethibond 2#线于胫骨髁间棘撕脱骨折处交叉固定，经骨隧道引出固定于胫骨结节内侧。结果 24例患者全部均获得随访，随访时间3～15个月，平均 10.7个月。X线片示骨折全部愈合，所有病例膝关节屈伸功能正常。结论 关节镜辅助下尼龙编织缝线固定胫骨髁间棘撕脱骨折具有创伤小、关节功能障碍发生率低的优点，是一种可靠的方法。
【关键词】 骨折;胫骨髁间棘;关节镜;内固定术
Arthroscopic fixation of avulsion fractures of tibial intercondylar
eminence using nylon-woven suture
MAO Xin, XIONG Chuanzhi, WANG Tao, YANG Shanhua, XU Ronghua
(Department of Orthopedics, Xuzhou Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China)
Abstract:Objective To investigate the methods and effects of arthroscopic treatment of avulsion fractures of tibial intercondylar eminence using nylon woven suture fixation.Methods Arthroscopic reduction of avulsion fracture of tibial intercondylar eminence was performed by taking advantage of anterior cruciate ligament (ACL) reamer and drilling four bone tunnels medial to the tibial tuberosity, and then the fracture was cross-fixed by 2 Ethibond 2# sutures and the sutures were pulled out through drilled tunnels and tied onto the medial surface of the tibial tuberosity.Results All the 24 patients were followed up for 3-15 months, at an average of 10.7 months. The clinical results were proved to be satisfactorily healed radiographically. The degrees of flexion and extension of the knee joints were normal.Conclusion Arthroscopic fixation of avulsion fractures of tibial intercondylar eminence using nylon-woven suture has the advantages of being less invasive, less dysfunctional and more reliable.
Key words: fracture; tibial intercondylar eminence; arthroscopy; fixation
胫骨髁间棘骨折是一种常见的关节内骨折，移位明显者采用非手术治疗常会引起骨折不愈合，前交叉韧带功能受损 ,从而导致膝关节不稳定、膝关节撞击征等功能障碍。治疗上常规采用切开复位钢丝或螺钉固定的方法，手术创伤大，需切开关节囊，膝关节功能障碍发生率高[1]。2005年3月—2008年4月笔者采用关节镜辅助下复位尼龙编织缝线固定此种骨折24例， 取得了很好的疗效， 现报道如下。
1 资料和方法
1.1 一般资料 本组患者共24例,男15例,女9例;年龄12～56岁,平均35.4岁。损伤原因:车祸伤11例,运动伤7例,摔伤6例。所有病例均为
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