Arthroscopic treatment for aged anterior tibial spine fracture with absorbable suture fixation in children

Q4 Medicine

中华小儿外科杂志 Pub Date : 2019-12-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2019.12.013

Xiaoliang Chen, Zhi-guo Zhou, Xiong-tao Li, Ji Wu, Ping Zhang

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引用次数: 0

Abstract

Objective To explore the efficacies of arthroscopic treatment for aged anterior tibial spine fracture with polydioxanone (PDS-II) suture fixation in children and to provide an effective, safe, reliable and mini-invasive treatment for old anterior tibial spine fracture. Methods Retrospective analysis was performed for 7 children with old tibial intercondylar spine fracture from January 2014 to January 2017. There were 5 boys and 2 girls. According to the Meyers & McKeever classification scheme, the fractures were divided into type Ⅱ (n=3) and type Ⅲ (n=4). All of them underwent arthroscopic reduction and PDS-Ⅱ absorbable suture for fixation. Gypsum was removed at 4 weeks postoperatively and functional exercises began. Weight was partially loaded at 6 weeks post-operation and completely loaded at 12 weeks postoperatively. Lysholm knee score was employed for evaluating knee functions before operation and at the last follow-up. At the last follow-up, standing plain films of both lower extremities were taken for recording the length of both lower extremities and the presence of varus deformity of knee joint. Results The average follow-up period was 15.3(12-18) months. All of them achieved primary healing within 3 months. The average motion range of knee joints normalized at 3 months postoperatively. There was no limitation of knee extension/flexion, pain or swelling of knee joint. Both anterior drawer and Lachman tests were negative. The average Lysholm score at the last follow-up was (93.8±3.1) as compared with the preoperative Lysholm score of (42.7±2.7). And the difference was statistically significant (t=63.96, P<0.01). Conclusions Arthroscopic fixation with absorbable suture is both safe and effective for old tibial intercondylar spine fracture in children. As a mini-invasive procedure, its curative effect is satisfactory and wider popularization is recommended. Key words: Arthroscopy; Tibial spine fracture; Old fracture

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关节镜下儿童可吸收缝线固定治疗老年胫骨前棘骨折

目的探讨关节镜下聚二氧环酮(PDS-II)缝合固定治疗儿童老年胫骨前棘骨折的疗效，为老年胫骨前棘骨折提供一种有效、安全、可靠的微创治疗方法。方法回顾性分析2014年1月至2017年1月收治的7例老年性胫骨髁间骨折患儿的临床资料。有5个男孩和2个女孩。根据Meyers & McKeever分类方案，将骨折分为Ⅱ型(n=3)和Ⅲ型(n=4)。所有患者均行关节镜复位和PDS-Ⅱ可吸收缝线固定。术后4周取出石膏，开始功能锻炼。术后6周部分负重，12周完全负重。术前及末次随访时采用Lysholm膝关节评分评价膝关节功能。最后随访时，拍摄双下肢站立平片，记录双下肢长度及膝关节内翻畸形情况。结果平均随访时间15.3(12 ~ 18)个月。所有患者均在3个月内获得初步愈合。术后3个月膝关节平均活动范围恢复正常。没有限制膝关节的伸展/屈曲，膝关节疼痛或肿胀。前抽屉试验和拉赫曼试验均呈阴性。末次随访时平均Lysholm评分为(93.8±3.1)分，术前Lysholm评分为(42.7±2.7)分。差异有统计学意义(t=63.96, P<0.01)。结论关节镜下可吸收缝线固定治疗儿童老年性胫骨髁间骨折安全有效。作为一种微创手术，其疗效满意，值得广泛推广。关键词:关节镜;胫骨骨折;老骨折

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.