Hua Guo-jun, Liu Yun-peng, Xu Pei-rong, Luo Yu-chun
Orthopaedics Department, the 101th Hospital of PLA , Wuxi 214044, Jiangsu, China.
Zhongguo Gu Shang. 2011 Sep;24(9):723-5.
To analyze the characteristics of children tibial intercondylar eminence fractures, and introduce arthroscopic minimally invasive techniques for the treatment of tibial intercondylar eminence fractures in children.
From January 2004 to December 2008, 12 children with tibial intercondylar eminence fractures were treated with cross Kirschner wire fixation after arthroscopic reduction. According to Meyers-McKeever classification systems, there were 1 case of type I, 4 cases of type II, and 7 cases of type III. There were 10 fresh and 2 old fractures in all. Among the patients, 10 patients were boy and 2 patients were girl,ranging in age from 8 to 13 years, with an average of 10 years. All the patients underwent arthroscopic exploration, reduction and fixation. During follow-up ranging from 10 to 36 months, the union of fracture, range of motion and stabilization of the knee were assessed. One patient was combined with lesions of the menisci, 1 patient with femoral trochlea cartilage injury, and 5 patients with meniscal entrapment under the bone.
The heeling time averaged 5 weeks. No knee laxity or instability and no intercondylar notch impingement was detected in all cases at 3 months postoperatively. At same time, full range of motion of the affected knee returned, and the average Lysholm knee score was (92.7 +/- 2.5), the average Lysholm knee score was (96.4 +/- 1.7) at 6 months postoperatively. The Lachman test and ADT test was negative.
The type II and type III tibial intercondylar eminence fractures occur frequently in children. Lesions of the menisci and cartilage occur seldom. The method of arthroscopic cross Kirschner wire fixation for the treatment of tibial intercondylar eminence fracture is easy to operate. Simultaneously, this technique is less invasive and allows early recovery. Also it coincidences with the characteristic rapid bone growth of children.
分析儿童胫骨髁间隆起骨折的特点，介绍关节镜微创技术治疗儿童胫骨髁间隆起骨折。
2004年1月至2008年12月，对12例儿童胫骨髁间隆起骨折患者行关节镜下复位后交叉克氏针固定治疗。按Meyers-McKeever分类系统，Ⅰ型1例，Ⅱ型4例，Ⅲ型7例。共新鲜骨折10例，陈旧骨折2例。患者中男10例，女2例，年龄8～13岁，平均10岁。所有患者均行关节镜探查、复位及固定。随访10～36个月，评估骨折愈合情况、膝关节活动度及稳定性。1例合并半月板损伤，1例合并股骨滑车软骨损伤，5例合并半月板骨下嵌顿。
愈合时间平均5周。术后3个月所有病例均未发现膝关节松弛或不稳定，未发现髁间切迹撞击。同时，患侧膝关节恢复了全范围活动，术后6个月Lysholm膝关节平均评分为(96.4±1.7)，术后3个月平均评分为(92.7±2.5)。Lachman试验和ADT试验均为阴性。
儿童胫骨髁间隆起骨折以Ⅱ型和Ⅲ型多见，半月板及软骨损伤少见。关节镜下交叉克氏针固定治疗儿童胫骨髁间隆起骨折操作简便，同时具有创伤小、恢复早的特点，符合儿童骨骼生长快的特点。
