Laxity and functional outcome after arthroscopic reduction and internal fixation of displaced tibial spine fractures in children
Laxity and functional outcome after arthroscopic reduction and internal fixation of displaced tibial spine fractures in children
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DOI：
10.1016/j.arthro.2003.10.014
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发表时间：
2003-12-01
影响因子：
4.7
通讯作者：
Micheli, LJ
中科院分区：
文献类型：
--
作者：
Kocher, MS;Foreman, ES;Micheli, LJ
目的：本研究的目的是评估关节镜下复位和内固定治疗骨未成熟患者移位性胫骨骨折的松弛性和功能结局。研究类型：回顾性病例系列。方法：6例患者（平均年龄12.0岁）在关节镜复位和3.5 mm空心螺钉固定（Meyers和McKeever III型）胫骨骨折后，在至少2年（平均3.2年）的随访时间内进行了主观、客观和有器械的膝关节松弛度评估。结果：体格检查显示持续松弛，6例患者中5例拉赫曼检查异常，6例患者中2例枢轴移位检查异常。6例患者中有4例的人工膝关节松弛度（KT-1000）显示超过3mm的手动最大侧对侧差异。功能评估显示功能良好，平均Lysholm评分为99.5分（范围98-100），平均Marshall评分为49.0分（范围47-50），平均Tegner评分为8.7分（范围7-9）。结论：关节镜下复位内固定治疗骨骼发育不成熟的III型胫骨骨折患者可获得持续的松弛，但功能预后良好。
Purpose: The purpose of this study was to evaluate laxity and functional outcome of displaced tibial spine fractures in skeletally immature patients treated with arthroscopic reduction and internal fixation. Type of Study: Retrospective case series. Methods: Six patients (mean age, 12.0 years old) underwent subjective, objective, and instrumented knee laxity assessment at minimum 2 years (mean, 3.2 years) of follow-up time after arthroscopic reduction and 3.5-mm cannulated screw fixation of (Meyers and McKeever type III) tibial spine fractures. Results: Physical examination showed persistent laxity, with an abnormal Lachman examination in 5 of 6 patients and an abnormal pivot-shift examination in 2 of 6 patients. Instrumented knee laxity (KT-1000) showed greater than 3-mm manual-maximum side-to-side difference in 4 of 6 patients. Functional assessment revealed excellent function, with a mean Lysholm score of 99.5 (range, 98-100), mean Marshall score of 49.0 (range, 47-50), and mean Tegner score of 8.7 (range, 7-9). Conclusions: Arthroscopic reduction and internal fixation of type III tibial spine fractures in skeletally immature patients results in persistent laxity but excellent functional outcome.