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儿童胫骨髁间棘骨折的关节镜固定技术:综述

Arthroscopic fixation techniques for tibial eminence fractures in pediatric patients: a review.

作者信息

Li Canfeng, Huang Xiancheng, Yang Qingjun, Luo Yong, Li Jiatong, Ye Sufen, Lu Wenqian, Zhang Xintao, You Tian

机构信息

Sports Medicine and Rehabilitation Center, Peking University Shenzhen Hospital, Shenzhen, China.

Clinical Medical College, Weifang Medical University, Weifang, China.

出版信息

Front Pediatr. 2024 Mar 26;12:1347637. doi: 10.3389/fped.2024.1347637. eCollection 2024.

Abstract

The introduction of new internal fixation devices and arthroscopic techniques has led to significant changes in the surgical treatment of tibial eminence fractures (TEFs) in children. In recent years, arthroscopic surgery has arisen as the gold standard for the treatment of TEFs. This popularity of arthroscopic techniques has reduced surgical complications and improved patient prognosis. In this paper, we investigate the current situation of the use of arthroscopic fixation techniques for pediatric TEFs. We searched the PubMed database using the terms "arthroscopic treatment and tibial eminence," "arthroscopic treatment and tibial spine," "tibial eminence avulsion", "tibial spine fracture", with no limit on the year of publication. From these articles, we reviewed the use of various arthroscopic TEFs fixation techniques reported in the current literature. Overall, we found that the choice of fixation method seems to have no effect on clinical outcomes or imaging results. However, if an easy, strong fixation that is less prone to epiphyseal damage is desired, as a junior practitioner, the anchor technique should be mastered first, whereas for senior practitioners, a variety of fixation techniques for TEFs should be mastered, including anchors, sutures, and screws, so that personalized fixation can be achieved with the least amount of trauma, operative time, and complications. Higher quality studies are needed in the future to provide Useful evidence to determine the optimal fixation technique in terms of clinical outcomes, function, and complications.

摘要

新型内固定装置和关节镜技术的引入,使儿童胫骨髁间棘骨折(TEF)的外科治疗发生了显著变化。近年来,关节镜手术已成为治疗TEF的金标准。关节镜技术的广泛应用减少了手术并发症,改善了患者预后。在本文中,我们调查了小儿TEF关节镜固定技术的应用现状。我们使用“关节镜治疗与胫骨髁间棘”、“关节镜治疗与胫骨棘”、“胫骨髁间棘撕脱”、“胫骨棘骨折”等关键词检索了PubMed数据库,对发表年份没有限制。从这些文章中,我们回顾了当前文献报道的各种关节镜下TEF固定技术的应用情况。总体而言,我们发现固定方法的选择似乎对临床结果或影像学结果没有影响。然而,如果希望获得一种简单、牢固且不易造成骨骺损伤的固定方法,作为初级从业者,应首先掌握锚钉技术;而对于高级从业者,则应掌握多种TEF固定技术,包括锚钉、缝线和螺钉,以便以最少的创伤、手术时间和并发症实现个性化固定。未来需要更高质量的研究来提供有用的证据,以确定在临床结果、功能和并发症方面的最佳固定技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6334/11002092/375f1bab0e73/fped-12-1347637-g001.jpg

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