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关节镜下使用半月板拉钩®治疗儿童和青少年移位胫骨棘骨折。

The arthroscopic treatment of displaced tibial spine fractures in children and adolescents using Meniscus Arrows®.

机构信息

Department of General Surgery, Traumatology and Arthroscopic Surgery, TweeSteden Hospital, Dr. Deelenlaan 5, 5042 AD, Tilburg, The Netherlands.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2011 May;19(5):736-9. doi: 10.1007/s00167-010-1341-8. Epub 2010 Dec 11.

Abstract

PURPOSE

This article summarises the results of a newly developed technique that utilises Meniscus Arrows(®) for the arthroscopic fixation of displaced tibial spine fractures in children and adolescents.

METHOD

Twelve tibial spine fractures in the knees of eleven children between 6 and 15 years old, with an average age of 12 years, were arthroscopically fixed with Meniscus Arrows(®), after a reduction of their fractures. This was followed by 5 weeks immobilisation in a plaster of Paris. Postoperative follow-up included radiographs, Lachmann tests on all of the children's knees and KT-1000 tests of eight out of twelve of the children's knees. The postoperative follow-up time ranged from 3 to 10 years, with patients being seen for an average of 4 years.

RESULTS

All of the fractures consolidated uneventfully, and all of the patients returned unrestricted to their previous activity level. The Lachmann tests revealed no, or a non-functional, laxity in any of the patients' knees. The KT-1000 tests showed a difference between the operated side, and non-operated side, of between 3 mm in the first knee operated on and an average of 1 mm in the remaining knees.

CONCLUSION

The arthroscopic fixation of tibial spine fractures using Meniscus Arrows(®) showed that this minimally invasive procedure resulted in the uneventful consolidation of all twelve of the fractures, with excellent results, and without the need for a second, hardware removal, operation.

LEVEL OF EVIDENCE

Level IV.

摘要

目的

本文总结了一种新开发技术的结果,该技术利用半月板箭(®)对儿童和青少年移位胫骨棘骨折进行关节镜固定。

方法

对 11 名 6 至 15 岁(平均年龄 12 岁)儿童的 12 例膝关节胫骨棘骨折进行关节镜下半月板箭(®)固定,骨折复位后。随后,用石膏固定 5 周。术后随访包括 X 线检查、所有患儿的 Lachmann 试验和 12 例患儿中的 8 例的 KT-1000 试验。术后随访时间为 3 至 10 年,平均随访 4 年。

结果

所有骨折均顺利愈合,所有患者均无限制地恢复到之前的活动水平。Lachmann 试验显示,所有患者的膝关节均无或存在非功能性松弛。KT-1000 试验显示,在接受第一次手术的膝关节中,手术侧与非手术侧之间的差异为 3mm,而在其余膝关节中平均为 1mm。

结论

半月板箭(®)关节镜下固定胫骨棘骨折表明,这种微创治疗方法可使 12 例骨折顺利愈合,结果良好,无需进行第二次、硬件去除手术。

证据等级

IV 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b10/3076577/b7294f47f04c/167_2010_1341_Fig1_HTML.jpg

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