缝线锚钉与钻孔缝合修复股四头肌髌骨止点断裂的疗效比较  

Suture anchor versus drilling suture for reconstruction of distal rupture of the quadriceps femoris

作　　者：谭晓毅[1] 杜远立[1] 覃涛[1] 蔡瑾[2] 

机构地区：[1]三峡大学人民医院（宜昌市第一人民医院）骨科,湖北省宜昌市443000 [2]三峡大学人民医院手术室,湖北省宜昌市443000

出　　处：《中华创伤骨科杂志》2011年第9期836-839,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的比较缝线锚钉与钻孔缝合修复股四头肌髌骨止点断裂的疗效。方法回顾性分析2000年1月至2008年10月采用缝线锚钉法或钻孔缝合法治疗的42例股四头肌髌骨止点断裂患者资料，根据患者收治时间段及修复方法不同分为两组：传统组（采用钻孔缝合修复）21例，男18例，女3例；平均年龄（27．0±6．2）岁（19～41岁）。锚钉组（采用缝线锚钉修复）21例，男16例，女5例；平均年龄（24．0±5．4）岁（16～37岁）。比较两组患者的手术时间、切口长度、出血量及外固定时间等，并采用Lysholm评分标准和美国膝关节协会评分（KSS）标准对膝关节功能进行评定。结果42例患者术后获2～3年（平均2．7年）随访。两组患者在手术时间、切口长度、出血量、外固定时间及髌骨位置方面差异均有统计学意义（P〈0．05）。两组患者切口均一期愈合，传统组14例患者于术后1年手术取出钢丝；锚钉组未再次手术，末次随访时锚钉位置正常。传统组膝关节功能Lysholm评分平均为（90．0±8．7）分，锚钉组平均为（95．0±4．5）分，两组比较差异无统计学意义（t=-1．333，P=0．190）。按KSS评分标准评定疗效：传统组优8例，良8例，可5例，优良率为76．2％；锚钉组优14例，良5例，可2例，优良率为90．5％。结论缝线锚钉与钻孔缝合修复股四头肌髌骨止点断裂均可取得满意疗效。相比较而言，缝线锚钉创伤小、操作简便、固定效果更好，可以早期开始功能锻炼，是治疗股四头肌髌骨止点断裂的一种较好方法。Objective To compare clinical outcomes of suture anchor and drilling suture for reconstruction of distal rupture of the quadriceps femoris. Methods From January 2000 to October 2008, 42 patients with distal rupture of the quadriceps femoris were treated with suture anchor or drilling suture at our department. In the drilling suture group, there were 18 men and 3 women, aged from 19 to 41 years （average, 27.0 ±6. 2 years） . In the suture anchor group, there were 16 men and 5 women, aged from 16 to 37 years （average, 24. 0± 5.4 years）. The 2 groups were compared in operation time, incision length, bleeding volume, and external fixation time, as well as Lysholm scores and American Knee Society Score（KSS） for functional recovery of the knee. Results All the patients were followed up for 2 to 3 years（average, 2. 7 years）. There were significant differences between the 2 groups in operation time, incision length, bleeding volume, external fixation time and patella position（ P 〈 0. 05） . All the patients obtained primary healing of wounds. Fourteen patients in the drilling suture group had their steel wire pulled out one year after surgery, but none in the suture anchor group needed a secondary operation. The average Lysholm score was 90. 0 ± 8.7 points for the drilling suture group, with no significant difference from that for the suture anchor groups （95.0 ±4. 5） （ t =- 1. 333, P = 0. 190）. By KSS system, there were 8 excellent, 8 good and 5 fair cases in the drilling suture group （with an excellent to good rate of 76. 2% ）; while there were 14 excellent, 5 good and 2 fair cases in the suture anchor group （with an excellent to good rate of 90. 5% ）. Conclusion Although both suture anchor and drilling suture can achieve satisfactory therapeutic effects in reconstruction of distal rupture of the quadriceps femoris, suture anchor method may be superior because of less invasion, more simplicity, better stability and earlier functional rehabilitation.

关 键 词：缝线 骨钉 创伤和损伤 四头肌 髌骨 

分 类 号：R687.3[医药卫生—骨科学]