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关节镜下三滑轮技术复位与内固定治疗儿童胫骨结节骨折:回顾性分析。

Arthroscopic tri-pulley Technology reduction and internal fixation of pediatric Tibial Eminence fracture: a retrospective analysis.

机构信息

Sport Medicine Center, Honghui Hospital Affiliated with the School of Medicine, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China.

Anesthesiology Department, Honghui Hospital Affiliated with the School of Medicine, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China.

出版信息

BMC Musculoskelet Disord. 2020 Jun 29;21(1):408. doi: 10.1186/s12891-020-03421-z.

Abstract

BACKGROUND

Fixing a tibial eminence fracture with a tri-pulley is a new technique. The purpose of this study was to present the early clinical outcome of arthroscopic tri-pulley suture fixation for tibial eminence fractures in children.

METHODS

Twenty-one pediatric patients with type II or type III anterior tibial eminence fractures were included in this retrospective study. All Patients underwent surgical fixation by tri-pulley technology and were followed up for at least 24 months. They were evaluated preoperatively and postoperatively by physical, X-ray, and computed tomography (CT) examination and subjectively with the International Knee Documentation Committee (IKDC), and Lysholm questionnaires.

RESULTS

The patients included 12 males and 9 females; mean age, 12.5 years (range, 8 ~ 16 years). They were followed-up for a median of 27 months (range, 24 ~ 39 months). We did not find post-operative instability in any of the patients by physical examination. The KT-2000 difference of both knees decreased from 9.3 ± 1.2 mm preoperatively to 2.6 ± 0.8 mm 24 months postoperatively (P < 0.001); the IKDC subjective knee evaluation score improved from 43.1 ± 13.2 preoperatively to 83.8 ± 6.3 postoperatively (P < 0.001); and Lysholm improved from 48.3 ± 6.21 to 87.1 ± 9.8 (P < 0.001). No unhealed fractures or epiphyseal damage were reported in the postoperative X-ray and CT.

CONCLUSIONS

Arthroscopic tri-pulley fixation technology may provide a suitable technique for repair of tibial eminence fractures in skeletally immature patients.

LEVEL OF EVIDENCE

Case series; Level of evidence IV.

摘要

背景

使用三滑轮固定胫骨髁骨折是一种新技术。本研究旨在介绍关节镜下三滑轮缝合固定儿童胫骨髁骨折的早期临床结果。

方法

本回顾性研究纳入 21 例 II 型或 III 型前胫骨髁骨折患儿。所有患者均采用三滑轮技术进行手术固定,并至少随访 24 个月。术前、术后采用体格检查、X 线和计算机断层扫描(CT)检查以及国际膝关节文献委员会(IKDC)和 Lysholm 评分进行主观评估。

结果

患者包括 12 名男性和 9 名女性;平均年龄 12.5 岁(8 至 16 岁)。中位数随访时间为 27 个月(24 至 39 个月)。体格检查未发现任何患者术后不稳定。双膝 KT-2000 差值由术前的 9.3±1.2mm 减少至术后 24 个月的 2.6±0.8mm(P<0.001);IKDC 膝关节主观评分由术前的 43.1±13.2 提高至术后的 83.8±6.3(P<0.001);Lysholm 评分由术前的 48.3±6.21 提高至术后的 87.1±9.8(P<0.001)。术后 X 线和 CT 未见未愈合骨折或骺损伤。

结论

关节镜下三滑轮固定技术可为未成熟骨骼患者胫骨髁骨折的修复提供一种合适的技术。

证据等级

病例系列;证据等级 IV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f37/7325093/5a6a332b3c24/12891_2020_3421_Fig1_HTML.jpg

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