CAJ | 학술논문

目的探讨关节镜辅助下成人胫骨髁间棘骨折的微创治疗.方法在2006年1月至2008年5月期间共完成关节镜下成人胫骨髁间棘骨折修复固定22例,其中男12例,女10例;新鲜骨折18例,陈旧性骨折4例;按Meyers-McKeever骨折分型:Ⅱ型8例,Ⅲ型14例.22例骨折全部在关节镜下应用钢丝缝合固定.术后进行系统化的患肢康复训练,包括主动和被动伸屈关节(ROM),髌骨推移锻炼,进行股四头肌、胭绳肌、小腿肌的肌力锻炼,以及患膝的本体感觉训练.结果术后6个月对所有患者均进行随访和康复指导,并进行放射学和临床评估.放射学检查:术后8周,所有患者的骨折均获得骨性愈合;术后6个月所有患者患膝活动范围均达到了健侧水平,无疼痛症状;4例患者患膝关节有轻微的慢性肿胀.HSS膝关节临床功能评分:优18例,良4例.结论关节镜下钢丝缝合固定治疗胫骨髁间棘骨折具有手术创伤小、操作简便、固定可靠、术后康复快、并发症少等优点,同时可以发现并治疗关节内合并伤,能够最大程度恢复膝关节功能.
목적 탐토관절경보조하성인경골과간극골절적미창치료.방법 재2006년1월지2008년5월기간공완성관절경하성인경골과간극골절수복고정22례,기중남12례,녀10례;신선골절18례,진구성골절4례;안Meyers-McKeever골절분형:Ⅱ형8례,Ⅲ형14례.22례골절전부재관절경하응용강사봉합고정.술후진행계통화적환지강복훈련,포괄주동화피동신굴관절(ROM),빈골추이단련,진행고사두기、연승기、소퇴기적기력단련,이급환슬적본체감각훈련.결과 술후6개월대소유환자균진행수방화강복지도,병진행방사학화림상평고.방사학검사:술후8주,소유환자적골절균획득골성유합;술후6개월소유환자환슬활동범위균체도료건측수평,무동통증상;4례환자환슬관절유경미적만성종창.HSS슬관절림상공능평분:우18례,량4례.결론 관절경하강사봉합고정치료경골과간극골절구유수술창상소、조작간편、고정가고、술후강복쾌、병발증소등우점,동시가이발현병치료관절내합병상,능구최대정도회복슬관절공능.
Objective To evaluate the role of arthroscopieally assisted treatment of tibial emi-nence fractures in adults fixed with wire suture. Methods From January 2006 to May 2008,22 conseeu-tion patients with adult tibial eminence fractures were treated with wire fixation. There were 18 fresh frac-tures and 4 old ones; 12 males and 10 females. According to Meyers- McKeeve classification systems, there were 8 cases of type Ⅱ and 14 eases of type Ⅲ. Patients started postoperative rehabilitation com-plied with systematic protocol, included passive and active range of motion (RON), patellar movement, quadrieeps, hamstring and calf strength training, and proprioceptive training of the injured knee. Results All patients were followed up and assessed in 6 months. Radiologically, all cases showed a completely u-nion after 8 weeks. Clinically, all eases showed full range of motion without pain. Four cases showed mild chronic swelling. The outcome in all patients was graded as excellent, good, fair, and poor according to the hospital for special surgery (HSS) knee score. There were 18 excellent eases,4 good cases,none of fair and poor cases. No knee laxity pr instability was detected in all the cases, and the affected knees regained full range of motion. The Lachman test and anterior drawer test (ADT) were negative. Conclu-sions Arthrosopically assisted treatment of tibial eminence fracture can avoid arthrotomy of knee joint, help in diagnosis of other associated intra - articular injuries. It is easy and minimally invasive. It can lead to reliable reduction and fixation, and facilitate early rehabilitation. It may also give a better final outcome when compared with conventional arthrotomy.