McLennan J G
J Bone Joint Surg Br. 1982;64(4):477-80. doi: 10.1302/0301-620X.64B4.6896515.
Thirty-five patients were treated for Type III fractures of the intercondylar eminence of the tibia and were followed up for two to seven years. There were 20 Type IIIA fractures and 15 Type IIIB fractures. The avulsed fragment was reduced by operative arthroscopy and maintained either by extension and immobilisation in a cast or by crossed percutaneous pin fixation. Involvement of the medial collateral ligament or lateral meniscus was confirmed by valgus stress radiographs and by arthroscopy. Primary surgical repair through a separate incision was required in a significant number of patients. At follow-up, few patients suffered ligamentous instability, lack of extension, atrophy of the quadriceps, pain or effusion, and symptoms were minimal. Patients requiring surgical repairs of collateral ligaments or of peripheral detachments of the meniscus generally required a longer period of rehabilitation. Arthroscopic reduction and percutaneous pin fixation provided an effective treatment and significantly decreased the time spent in hospital and the morbidity experienced after alternative treatments.
35例患者接受了胫骨髁间隆起III型骨折的治疗，并随访了2至7年。其中有20例IIIA型骨折和15例IIIB型骨折。通过手术关节镜将撕脱碎片复位，并用石膏伸直固定或经皮交叉克氏针固定维持复位。通过外翻应力X线片和关节镜检查确认内侧副韧带或外侧半月板是否受累。相当多的患者需要通过单独切口进行一期手术修复。随访时，很少有患者出现韧带不稳定、伸直受限、股四头肌萎缩、疼痛或积液，症状轻微。需要手术修复侧副韧带或半月板周边附着处的患者通常需要更长的康复时间。关节镜下复位和经皮克氏针固定提供了一种有效的治疗方法，并显著减少了住院时间和替代治疗后的发病率。
