Thomson N L
Institute of Sports Medicine, Lewisham, Sydney, N.W.S., Australia.
Clin Orthop Relat Res. 1987 Nov(224):71-8.
Treatment of osteochondritis dissecans and osteochondral fragments using Herbert compression screw fixation combined with drilling gives satisfactory results. The Herbert screws may be inserted arthroscopically after identifying the lesion. The need for arthrotomy is eliminated in most instances. Management was by drilling and pinning for unseparated lesions and crater preparation with fragment fixation in cases with separated osteochondral fragments. The follow-up period is only four to 28 months. One case required arthrotomy. Ten patients with a four-month to five-year history of knee pain had unseparated lesions. Eight had excellent results with union, one required drilling and removal of sequestrae, and one remains unhealed. Three cases had separated osteochondral fragments. All three appear to have obtained union of the separated fragments without recurrence of separation.
使用Herbert加压螺钉固定联合钻孔治疗剥脱性骨软骨炎和骨软骨碎片，效果令人满意。在确定病变后，可通过关节镜插入Herbert螺钉。在大多数情况下无需进行切开手术。对于未分离的病变，采用钻孔和打钉处理；对于分离的骨软骨碎片病例，则进行骨坑准备并固定碎片。随访期仅4至28个月。1例需要切开手术。10例有4个月至5年膝关节疼痛病史的患者有未分离的病变。8例愈合良好，1例需要钻孔并清除死骨，1例仍未愈合。3例有分离的骨软骨碎片。所有3例分离的碎片似乎均已愈合，未再次分离。
