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

doi:10.13481/j.1671-587x.20190338

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. 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. 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/Abstract

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

李颖智, 于海驰, 李秋菊, 王金成, 刘晓宁, 董晓明, 绳越, 关文启, 史景平, 董双, 高美玲, 赵云婷, 杨大伟. 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[J]. 吉林大学学报(医学版), 2019, 45(03): 692-696.

LI Yingzhi, YU Haichi, LI Qiuju, WANG Jincheng, LIU Xiaoning, DONG Xiaoming, SHENG Yue, GUAN Wenqi, SHI Jingping, DONG Shuang, GAO Meiling, ZHAO Yunting, YANG Dawei. Surgery treatment of Meyers-Mckeever-Zaricnyj type Ⅳ tibial eminence fracture patients under arthroscope: A report of 7 cases and literature review[J]. Journal of Jilin University(Medicine Edition), 2019, 45(03): 692-696.

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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

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

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