Arthroscope-guided Bone Grafting and Suture Fixation for Nonunion of Tibia Intercondylar Eminence Fracture
XU Hai-tao1,ZHU Wei-hong2,CAO Bin1,SHU Zi-zhen1
1.Department of Orthopaedics,The Second People's Hospital of Hunan Province,Changsha410007,Hunan,China; 2.Department of Orthopaedics,The Second Xiangya Hospital,Central South University,Changsha410011,Hunan,China
Abstract: ObjectiveTo explore the effect and safety of arthroscope-guided bone grafting and suture fixation for nonunion of tibia intercondylar eminence fractures.MethodsFrom July 2014 to October 2016, a total of 8 cases with tibia intercondylar eminence fracture nonunion were treated by arthroscope-guided bone grafting and fixation with suture, including 4 of type Ⅱ and 4 of type Ⅲ. Lysholm knee score and Rang of motion of knee were assessed before, 3-, 6- and 12 months after the surgery. Anterior drawer test (ADT) and Lachman test were used to evaluate knee stability. Loose bodies were observed by X-image.ResultsAll 8 cases accomplished the surgery successfully. Combined meniscus injury were found in 6 cases, including medial meniscus in 2, lateral meniscus in 1 and medial-lateral in 3; Combined articular cartilage lesion was found in 4 cases. During the surgery, autogenous bone grafting was performed in 6 cases and allogenetic bone grafting in 2 cases. Followed-up duration ranged from 12 to 20 months in 7 patients, but loss in 1 case 2 months after the surgery. All knees achieved full extention and 130° in flexion at least. The fracture healing time was 3 months in 6 cases and 4 months in 1 case. There were negative outcomes in 5 cases and positive outcomes in 2 cases in both ADT and Lachman test 6- and 12 months after the surgery, but no patient felt instable. No loose body was observed 12 months after the operation. The average Lysholm knee score of 6- and 12 months after the surgery was 91.4±7.1 and 96.6±4.6 respectively, both were improved significantly than 82.9±7.3 of pre-operation, and the differences were statistically (t=8.042，P<0.05, andt=9.731，P<0.05).ConclusionThe surgical intervention of arthroscope-guided bone grafting and suture fixation is safe and effective for fracture nonunion of tibia intercondylar eminence.
徐海涛1, 朱威宏2, 曹斌1, 舒子震1. 关节镜引导下植骨、缝线内固定治疗胫骨髁间嵴骨折不愈合[J]. 中国现代手术学杂志, 2017, 21(6): 445-448.
XU Hai-tao. Arthroscope-guided Bone Grafting and Suture Fixation for Nonunion of Tibia Intercondylar Eminence Fracture. Chinese Journal of Modern Operative Surgery, 2017, 21(6): 445-448.
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2017, Vol. 21 
