Hirschmann Michael T, Mayer Ralph R, Kentsch Axel, Friederich Niklaus F
Department of Orthopaedic Surgery and Traumatology, Kantonsspital Bruderholz, 4101, Bruderholz, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 2009 Jul;17(7):741-7. doi: 10.1007/s00167-009-0733-0. Epub 2009 Feb 19.
We describe a novel physeal sparing arthroscopic technique for anatomic suture refixation of tibial eminence fractures and assess the mid-term results of six consecutive patients (McKeever type II n = 2, III n = 3 and IV n = 1). The mean follow-up was 5 +/- 2 years. Five of six patients were painfree. All patients returned to their preinjury sport level. Mean passive ipsilateral and contralateral flexion was 143 degrees +/- 5 degrees. The IKDC score was A in five and B in one patients. The mean Lysholm score was 97 +/- 3%. The median Tegner score was 8 (range 6-9) preinjury and at follow-up. The mean Total Knee Society score was 197 +/- 4 points. ACL laxity (KT-1000 134 N) showed a side-to-side difference of 2 +/- 2 mm. Two of six patients underwent a tibial screw removal under local anaesthesia. No loss of reduction or grossly physeal disturbance was observed. The reported surgical technique showed excellent to good clinical and radiological results and may be a physeal sparing alternative to previously described procedures.
我们描述了一种用于胫骨髁间隆起骨折解剖复位缝线固定的新型保留骺板关节镜技术，并评估了连续6例患者（McKeever II型2例、III型3例和IV型1例）的中期结果。平均随访时间为5±2年。6例患者中有5例无疼痛。所有患者均恢复到受伤前的运动水平。患侧和对侧平均被动屈曲角度为143°±5°。国际膝关节文献委员会（IKDC）评分，5例为A级，1例为B级。Lysholm评分平均为97±3%。Tegner评分中位数在受伤前和随访时均为8（范围6 - 9）。全膝关节协会（Total Knee Society）评分平均为197±4分。前交叉韧带（ACL）松弛度（KT - 1000 134 N）显示两侧差异为2±2 mm。6例患者中有2例在局部麻醉下取出了胫骨螺钉。未观察到复位丢失或明显的骺板损伤。所报道的手术技术显示出良好至优秀的临床和放射学结果，可能是一种保留骺板的替代先前描述手术的方法。
