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目的探讨少儿膝关节半月板损伤的膝关节镜下微创手术治疗的特点及其临床效果。方法本组患儿29例,年龄8～16岁(平均11岁)。临床症状:患膝疼痛27例,弹响17例,交锁史13例,膝关节活动受限7例,跛行6例,膝部肿胀3例。膝关节间隙压痛28例,麦氏征阳性27例,MRI检查21例为阳性结果。所有患儿都采用关节镜下手术。术中见半月板边缘撕裂11例,桶柄样撕裂13例,其中撕裂缘嵌顿于髁间窝部5例,前角损伤3例,后角损伤2例。关节镜下半月板部分切除术3例,半月板缝合术26例。半月板缝合术后配戴支具,由专科治疗师行康复治疗。结果本组患儿随访15～182个月(平均38个月),所有患儿术后关节功能恢复正常。1例剧烈活动后时有膝部肿胀,无跛行。Lysolme评分:术前(62±9)分,术后(94±6)分,P<0.01;膝关节功能评分,术前(59±6)分,术后(93±5)分,P<0.01。结论少儿半月板损伤后多表现为交锁和关节活动受限。少儿半月板对膝关节正常功能影响很大,应尽可能采用半月板缝合术治疗。
Objective To investigate the characteristics and clinical effects of minimally invasive surgery under knee arthroscopy in children with knee meniscus injury. Methods The group of 29 children, aged 8 to 16 years (mean 11 years). Clinical symptoms: 27 cases of knee pain, 17 cases of snapping, 13 cases of history of interlocking, 7 cases of limited knee mobility, 6 cases of claudication and 3 cases of knee swelling. 28 cases of knee joint tenderness, Mark’s positive sign in 27 cases, MRI examination of 21 cases were positive. All children underwent arthroscopic surgery. In operation, 11 cases were found on the edge of the meniscus and 13 cases were buckled on the barrel. Teeth was implanted in the intercondylar fossa in 5 cases. There were 3 cases of anterior horn injury and 2 posterior horn injuries. Arthroscopic meniscus partial resection in 3 cases, meniscal suture in 26 cases. Meniscal suture after wearing brace, rehabilitation specialist by specialist treatment. Results The children were followed up for 15 to 182 months (average 38 months), and all children recovered to normal postoperative joint function. 1 case of severe knee swelling after activity, no limp. The scores of Lysolme score before surgery were (62 ± 9), postoperative (94 ± 6), P <0.01; knee function score, preoperative (59 ± 6), postoperative (93 ± 5) 0.01. Conclusion Children’s meniscus injury and more performance for the interlocking and joint activity is limited. Children’s meniscus a great influence on the normal function of the knee should be treated with meniscal suture as much as possible.