【摘要】 目的 探讨关节镜下复位并内固定治疗胫骨髁间棘骨折的手术方法及疗效。方法 对14例MeyersMckeever Ⅱ、Ⅲ、Ⅳ的胫骨髁间棘骨折患者施行关节镜下复位及内固定术。在关节镜监视下,对移位或翻转的粉碎骨折块进行复位,用不可吸收缝合线或自攻空心松质骨螺钉对骨折块行内固定,同时处理合并伤。术后使用支具于伸膝位制动4～6周,术后给予相应阶段的康复指导。结果 全部患者术后骨折愈合良好，伤膝关节活动度与健侧一致，关节稳定。结论 对于胫骨髁间棘骨折,根据患者年龄、骨折类型、选取适合的内固定方式，在关节镜监视下完全可以做到满意的骨折整复,可靠的内固定,重建前交叉韧带的稳定性。关节镜下复位、内固定手术创伤小，较膝关节开放手术具有明显优越性。
【关键词】 胫骨髁间棘;骨折;交叉韧带;膝关节;关节镜
Surgery treatment for tibial intercondylar eminence fracture under arthroscopy
XIE Jie,HUANG Zhang,PAN Liangchun,et al.
(Department of Orthropedics,Third Affiliated Hospital of Anhui Medical University,First People s Hospital of Hefei,
Hefei 230061,China)
Abstract： Objective To evaluate the efficacy and operation techniques of the surgery treatment for tibial intercondylar eminence fracture under an arthroscopy.Methods Totally 14 cases of tibial intercondylar eminence fractures underwent reduction and internal fixation under arthroscopy(MeyersMckeever Ⅱ，Ⅲ，Ⅳ).The fracture was reduced and fixed with nonabsorbable suture or cannulated screws.The associated injury was treated at the same time.The injured leg was fixed by brace on kneeextended position for 4～6 weeks after operation.Rehabilitation instructions were performed according to different stages.Results All fractures healed.Injured joints were stabilized with normal motion.Conclusion The method of the internal fixation should be performed according to age,types of the tibial intrecondylar eminence fracture under an arthroscopy,resulting in precise reduction,reliable fixation,and superior to the open reduction.
Key words：tibial eminence;fracture;cruciate ligament;knee joint;arthroscopy
前交叉韧带胫骨止点胫骨髁间棘撕脱骨折是常见的膝关节损伤，损伤机制与前交叉韧带损伤相似，处理不当可能出现膝关节不稳、髁间撞击症、膝伸直受限症状。目前观点对于无明显移位的骨折即MeyersMckeever Ⅰ型可通过保守治疗，但对于骨折移位的即MeyersMckeever Ⅱ、Ⅲ、Ⅳ型需要手术复位固定。我院应用关节镜辅助下进行胫骨髁间棘骨折的复位内固定，术后临床疗效良好，现报告如下。
临床资料
1 一般资料
我院自2005年10月～2008年7月对14例胫骨髁间棘骨折施行了关节镜下复位及内固定手术。其中男性5例,女性9例;
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