胫骨结节撕脱骨折块的内镜下切除及髌腱的内镜辅助修复
Endoscopic Resection of Avulsed Fragment of Tibial Tuberosity and Endoscopic-Assisted Repair of Patellar Tendon.
作者信息
Lui Tun Hing
机构信息
Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China.
出版信息
Arthrosc Tech. 2015 Dec 23;4(6):e851-4. doi: 10.1016/j.eats.2015.08.011. eCollection 2015 Dec.
An avulsion fracture of part of the tibial tuberosity can occur as a result of a tophaceous tuberosity or Osgood-Schlatter disease. We describe an endoscopic technique of debridement, bone fragment resection, and tendon repair. This technique has the potential advantage of fewer wound complications. It is performed through proximal and distal portals on the sides of the patellar tendon. The working space is deep to the tendon. After debridement of the tendon and resection of the bone fragment, the tendon gap is assessed. Endoscopic-assisted side-by-side repair is performed to close the gap if the gap is less than 30% of the width of the tendon. If the gap is more than 30% of the width of the tendon, the proximal stump of the avulsed tendon can be retrieved through the proximal portal. Krackow suture with stay stitches is applied to the proximal stump. The stump is put back and sutured to the tibial insertion through a bone tunnel or suture anchor. This is augmented by side-by-side suturing of the avulsed tendon with the adjacent normal tendon.
胫骨结节部分撕脱骨折可由痛风性结节或奥斯古德-施拉特病引起。我们描述了一种清创、骨碎片切除和肌腱修复的内镜技术。该技术具有伤口并发症较少的潜在优势。它通过髌腱两侧的近端和远端切口进行。工作空间位于肌腱深部。在对肌腱进行清创和切除骨碎片后，评估肌腱间隙。如果间隙小于肌腱宽度的30%，则进行内镜辅助的并排修复以闭合间隙。如果间隙大于肌腱宽度的30%，则可通过近端切口取出撕脱肌腱的近端残端。对近端残端应用带定位缝线的Krackow缝合。将残端放回并通过骨隧道或缝合锚钉缝合至胫骨附着处。通过将撕脱肌腱与相邻正常肌腱并排缝合来加强修复。
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