Loriaut Philippe, Moreau Pierre-Emmanuel, Loriaut Patrick, Boyer Patrick
Department of Orthopaedic Surgery and Sports Traumatology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013 Paris, France.
Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, 28 rue de Charenton 75012 Paris, France.
Indian J Orthop. 2017 Mar-Apr;51(2):187-191. doi: 10.4103/0019-5413.201706.
Avulsion fractures of the tibial intercondylar eminence are fairly common injuries requiring surgery for the optimal functional outcome. The purpose of this study was to assess the clinical and radiological outcomes of an arthroscopic treatment of displaced tibial intercondylar eminence fractures using a suspensory device.
Five patients with type 2 and 3 displaced tibial intercondylar eminence fractures who received an arthroscopically assisted fixation using a double button device were enrolled from 2011 to 2012. Clinical assessment included the patient demographics, cause of injury, the delay before surgery, time for surgery, time to return to work and sport, the International Knee Documentation Committee (IKDC) and Lysholm knee scores. Stability was measured with the KT-2000 arthrometer with a force of 134 N. A side to side difference on the KT-2000 examination superior to 3 mm was considered as a significant and abnormal increase in the anterior translation. Radiological examination consisted of anteroposterior and lateral radiographs, as well as computed tomography (CT) scan of the affected knee. Clinical and radiological followup was done at 1, 2, 3, 6, and 12 months postoperatively and at final followup. CT-scan was performed before surgery and at 3 months followup.
The median age of patients was 31 years. Mean followup was 27 ± 5.1 months. The average delay before surgery was 3 days. At final followup, the mean IKDC and Lysholm knee scores were, 93.9 and 94.5 respectively. All patients had a complete functional recovery and were able to return to work and to resume their sport activities. No secondary surgeries were required to remove hardware. No complication was noted. Bony union was achieved in all patients.
The arthroscopic treatment of displaced tibial intercondylar eminence fractures using a suspensory system provided a satisfactory clinical and radiological outcome at a followup of 2 years.
胫骨髁间隆起撕脱骨折是较为常见的损伤，为获得最佳功能预后需要进行手术治疗。本研究的目的是评估使用悬吊装置关节镜治疗移位性胫骨髁间隆起骨折的临床和影像学结果。
2011年至2012年纳入5例2型和3型移位性胫骨髁间隆起骨折患者，采用双纽扣装置进行关节镜辅助固定。临床评估包括患者人口统计学资料、损伤原因、术前延迟时间、手术时间、恢复工作和运动的时间、国际膝关节文献委员会（IKDC）和Lysholm膝关节评分。使用KT-2000关节测量仪以134 N的力测量稳定性。KT-2000检查中两侧差异超过3 mm被认为是前向移位显著且异常增加。影像学检查包括患膝的前后位和侧位X线片以及计算机断层扫描（CT）。术后1、2、3、6和12个月以及末次随访时进行临床和影像学随访。术前和随访3个月时进行CT扫描。
患者的中位年龄为31岁。平均随访时间为27±5.1个月。术前平均延迟时间为3天。在末次随访时，平均IKDC和Lysholm膝关节评分分别为93.9和94.5。所有患者均实现了完全功能恢复，能够恢复工作并重新开始体育活动。无需二次手术取出内固定物。未观察到并发症。所有患者均实现了骨愈合。
使用悬吊系统关节镜治疗移位性胫骨髁间隆起骨折在2年的随访中提供了令人满意的临床和影像学结果。
