Thaunat M, Barbosa N C, Gardon R, Tuteja S, Chatellard R, Fayard J-M, Sonnery-Cottet B
Ramsay Générale de Santé, Hôpital Privé Jean-Mermoz, Centre Orthopédique Santy, 24, avenue Paul-Santy, 69008 Lyon, France.
Ramsay Générale de Santé, Hôpital Privé Jean-Mermoz, Centre Orthopédique Santy, 24, avenue Paul-Santy, 69008 Lyon, France.
Orthop Traumatol Surg Res. 2016 Sep;102(5):625-9. doi: 10.1016/j.otsr.2016.05.009. Epub 2016 Jul 15.
Tibial spine avulsion fractures (TSAFs) occur chiefly in adolescents. Few published data are available on outcomes after arthroscopic surgical treatment of TSAFs in adults.
To evaluate outcomes of consecutive patients with TSAFs managed by arthroscopic bone suture followed by a standardised non-aggressive rehabilitation programme.
Arthroscopic bone suture followed by non-aggressive rehabilitation therapy reliably produces satisfactory outcomes in adults with TSAF.
Thirteen adults were included. Outcomes were evaluated based on the Tegner score, International Knee Documentation Committee (IKDC) score, anterior-posterior knee laxity, passive and active motion ranges, and radiological appearance.
After a mean follow-up of 41±27months (12-94months), all 13 patients had healed fractures without secondary displacement. No patient had knee instability. Post-operative stiffness was noted in 5 patients (2 with complex regional pain syndrome and 3 with extension lag), 1 of whom required surgical release. The mean IKDC score was 91.3±11.7. The mean Tegner score was 5.46±1.37 compared to 6.38±0.70 before surgery. Mean tibial translation (measured using the Rolimeter) was 1.09±1.22mm, compared to 5.9±1.85mm before surgery.
The outcomes reported here support the reliability of arthroscopic bone suture for TSAF fixation. Nevertheless, a substantial proportion of patients experienced post-operative stiffness, whose contributory factors may include stunning of the quadriceps due to the short time from injury to surgery and the use of a gentle rehabilitation programme.
IV, retrospective study of treatment outcomes.
胫骨棘撕脱骨折（TSAFs）主要发生于青少年。关于成人TSAFs关节镜手术治疗后的结果，鲜有公开数据。
评估连续接受关节镜下骨缝合及标准化非激进康复计划治疗的TSAFs患者的治疗结果。
关节镜下骨缝合联合非激进康复治疗能可靠地为成年TSAFs患者带来满意的治疗结果。
纳入13名成年患者。基于Tegner评分、国际膝关节文献委员会（IKDC）评分、膝关节前后向松弛度、被动和主动活动范围以及影像学表现评估治疗结果。
平均随访41±27个月（12 - 94个月）后，所有13例患者骨折均愈合，无二次移位。无患者出现膝关节不稳。5例患者出现术后僵硬（2例伴有复杂性区域疼痛综合征，3例伴有伸直滞后），其中1例需要手术松解。IKDC评分平均为91.3±11.7。与术前的6.38±0.70相比，Tegner评分平均为5.46±1.37。平均胫骨平移（使用Rolimeter测量）为1.09±1.22mm，术前为5.9±1.85mm。
本研究报告的结果支持关节镜下骨缝合用于TSAF固定的可靠性。然而，相当一部分患者出现术后僵硬，其促成因素可能包括从受伤到手术的时间短导致股四头肌失用，以及采用温和的康复计划。
IV级，治疗结果的回顾性研究。
