吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (03): 692-696.doi: 10.13481/j.1671-587x.20190338

• 临床医学 • 上一篇    

关节镜下手术治疗Meyers-Mckeever-Zaricnyj Ⅳ型胫骨髁间嵴骨折患者7例报告及文献复习

李颖智1, 于海驰1, 李秋菊1, 王金成1, 刘晓宁1, 董晓明1, 绳越1, 关文启1, 史景平1, 董双1, 高美玲1, 赵云婷1, 杨大伟2   

  1. 1. 吉林大学第二医院骨科中心运动医学科, 吉林 长春 130041;
    2. 中国中医科学院广安门医院南区骨二科, 北京 100053
  • 收稿日期:2018-08-17 发布日期:2019-06-05
  • 通讯作者: 杨大伟,副主任医师(Tel:010-81299633,E-mail:xiaoliuzi62000@sina.com) E-mail:xiaoliuzi62000@sina.com
  • 作者简介:李颖智(1977-),男,吉林省榆树市人,副主任医师,医学博士,主要从事运动医学方面的研究。
  • 基金资助:
    吉林省科技厅科研基金资助课题(20170204004GX)

Surgery treatment of Meyers-Mckeever-Zaricnyj type Ⅳ tibial eminence fracture patients under arthroscope: A report of 7 cases and literature review

LI Yingzhi1, YU Haichi1, LI Qiuju1, WANG Jincheng1, LIU Xiaoning1, DONG Xiaoming1, SHENG Yue1, GUAN Wenqi1, SHI Jingping1, DONG Shuang1, GAO Meiling1, ZHAO Yunting1, YANG Dawei2   

  1. 1. Department of Sports Medicine, Orthopaedics Center, Second Hospital, Jilin University, Changchun 130041, China;
    2. Department of Orthopaedics, GuangAnmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
  • Received:2018-08-17 Published:2019-06-05

摘要: 目的:观察Endobutton结合缝线治疗Meyers-Mckeever-Zaricnyj Ⅳ型胫骨髁间嵴骨折的疗效,探讨Ⅳ型骨折的特点和治疗方法。方法:收集7例Meyers-Mckeever-Zaricnyj Ⅳ型胫骨髁间嵴骨折患者的临床资料,结合相关文献,分析患者手术治疗方法、操作要点及注意事项。结果:经关节镜探查清理后,梳理出3块主骨折块:前交叉韧带连接骨块(ACLCF)、外侧半月板前角连接骨块(ALMCF)和后内侧软骨连续骨块(PMCCF),采用由后到前、由深到浅的顺序进行预复位,首先固定PMCCF,再固定ALMCF和ACLCF,避免骨隧道外口处骨桥切割继发移位。7例患者随访时间为6~12个月,平均随访时间为7个月。前抽屉试验(-),Lachman试验(-);患者术前平均Lysholm评分小于末次随访评分(P<0.05)。患者膝关节稳定性好,无运动障碍,无感染。结论:Meyers-Mckeever-Zaricnyj Ⅳ型髁间嵴骨折术中复位顺序至关重要,Endobutton结合缝线能够实现骨折块的完美固定。

关键词: 关节镜, Meyers-Mckeever-Zaricnyi Ⅳ型骨折, 胫骨髁间嵴骨折, 复位

Abstract: Objective:To observe the efficacy of Endobutton combined with the suture in the treatment of Meyers-Mckeever-Zaricnyj type Ⅳ tibial eminence fracture, and to explore the characteristics and treatment methods of Meyers-Mckeever-Zaricnyj type Ⅳ fracture. Methods:The clinical data of seven patients with Meyers-Mckeever-Zaricnyj type Ⅳ tibial eminence fracture were collected;the literature review was performed,and the surgical treatment methods,key points of operation and precautions of the patients were analyzed. Results:After arthroscopic debridement, 3 kinds of main fractures were found:anterior cruciate ligament connected fragment(ACLCF), anterior horn of lateral meniscus connected fragment(ALMCF), and posterior-medial cartilage connected fragment(PMCCF). The PMCCF was first fixed after pre-reduction from back to front and from deep to shallow orders, then the ALMCF and ACLCF were fixed, avoiding the secondary displacement and bone cutting. The follow- up periods of 7 patients were 6-12 months, with an average followed-up period of 7 months. The front drawer test (-), Lachman test (-);the average Lysholm score of patients before operation was less than that in the last follow-up period (P<0.05).The knee joint stability of patients was good, and the knee joint had no movement disorder and infection. Conclusion:The intra-operative reduction order is crucial during the operation of Meyers-Mckeever-Zaricnyj type Ⅳ tibial eminence fracture. Perfect fixation can be achieved by using Endobutton combined with suture.

Key words: arthroscope, Meyers-Mckeever-Zaricnyj type Ⅳ fracture, fracture of spine between tibia and ankle, reduction

中图分类号: 

  • R682.17