目的探讨关节镜下复位内固定治疗骨骺未闭青少年前交叉韧带(anterior cruciate ligament,ACL)撕脱骨折疗效。方法 2011年1月-2013年10月,收治35例单膝ACL撕脱骨折的骨骺未闭青少年患者,均于关节镜下复位内固定治疗。男25例,女10例;年龄8~16岁,平均14.7岁。致伤原因:运动伤24例,交通事故伤9例,日常生活损伤2例。根据Meyers-Mc Keever分型标准:Ⅱ型27例,Ⅲ型8例。合并半月板损伤5例。术前国际膝关节文献委员会(IKDC)评分为(48.7±3.2)分,Lysholm评分为(51.2±4.5)分。患者受伤至手术时间为2~16 d,平均5 d。结果术后切口均Ⅰ期愈合。患者均获随访,随访时间12~32个月,平均22.4个月。28例骨折解剖复位,7例接近解剖复位;末次随访时X线片复查示骨折均愈合。患肢无短缩畸形、双下肢不等长以及膝关节内、外翻畸形发生。Lachman试验均为阴性。术后6周1例膝关节屈曲受限,经对症处理后膝关节活动度恢复至0~120°;其余患者膝关节活动度均正常。末次随访时,IKDC评分及Lysholm评分分别为(93.2±4.1)、(96.2±2.5)分,均较术前显著提高,差异有统计学意义(t=—53.442,P=0.000;t=—56.242,P=0.000)。结论对于骨骺未闭青少年ACL撕脱骨折患者,关节镜辅助下复位内固定创伤小、恢复快,近期疗效满意。 Objective To investigate the effect of arthroscopic reduction and internal fixation in the treatment of avulsion fractures of anterior cruciate ligament (ACL) in young patients with epiphysis. Methods From January 2011 to October 2013, 35 patients with epiphyseal unruly adolescent ACL fractures were treated by arthroscopic reduction and internal fixation. 25 males and 10 females; aged 8 to 16 years, an average of 14.7 years old. Causes of injury: 24 cases of sports injuries, 9 cases of traffic accidents, 2 cases of daily life injuries. According to Meyers-Mc Keever classification criteria: 27 cases of type Ⅱ, 8 cases of type Ⅲ. Combined meniscus injury in 5 cases. Preoperative International Knee Documentation Committee (IKDC) score was (48.7 ± 3.2) points, Lysholm score was (51.2 ± 4.5) points. Patient was injured to surgery for 2 ~ 16 d, an average of 5 d. Results The incisions healed in the first stage. All patients were followed up for 12 to 32 months with an average of 22.4 months. Twenty-eight fractures were repaired anatomically, and 7 cases were close to anatomic reduction. At the last follow-up, X-ray examination showed that the fracture healed. No limb shortening deformity, unequal length of both lower extremities and knee, valgus deformity occurred. Lachman test were negative. One case of knee flexion was limited 6 weeks after operation. The knee mobility recovered to 0 ~ 120 ° after symptomatic treatment. The rest of the patients had normal knee activity. At the last follow-up, IKDC score and Lysholm score were (93.2 ± 4.1) and (96.2 ± 2.5) points respectively, which were significantly higher than those before operation (t = -53.442, P = 0.000; t = -56.242 , P = 0.000). Conclusion For epiphyseal adolescent ACL avulsion fracture patients, arthroscopy assisted reduction and internal fixation trauma, rapid recovery, the recent satisfactory results.