关节镜下空心螺钉与缝线固定治疗胫骨髁间棘骨折的疗效比较  

The comparison between arthroscopic cannulated screw and suture fixation on tibial spine fractures curative effect

作　　者：杨万波[1] 江红辉[1] 余鹏[1] 蒋从斌[1] 彭聚胜[1] 陈刚[1] 范华波[1] 

机构地区：[1]武警湖北总队医院骨1科,湖北武汉430061

出　　处：《生物骨科材料与临床研究》2013年第1期46-48,51,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的比较关节镜下空心螺钉与缝线固定治疗胫骨髁间棘骨折的临床及功能效果。方法回顾分析因胫骨髁间棘骨折接受关节镜下骨折固定治疗的28例患者资料,根据手术固定方法不同,将患者分为A、B两组,A组采用关节镜下空心螺钉固定;B组采用关节镜下缝线固定。对患者的手术时间、止血带应用时间等围手术期指标进行考察。在末次随访时,采用前抽屉试验、Lachman试验、特种外科医院评分(Hospital for Special Surgery,HSS)和Lysholm评分对膝关节的功能效果进行评估。结果共有23例患者获得最终24个月的临床及影像学随访,A组13例,B组10例。A组和B组的手术时间分为(180.3±12.7)min和(176.2±11.4)min,止血带应用时间分别为(113.7±10.4)min和(111.6±10.0)min,两组病例在手术时间和止血带应用时间方面,组间差异均无统计学意义(>0.05)。所有病例均获骨性愈合,均未出现骨折移位。末次随访时,患侧膝关节前抽屉试验、Lachman试验均为阴性;A、B两组的平均HSS评分分别为95.0±2.9和96.8±2.4,平均Lysholm评分分别为94.2±2.1和93.8±1.9,平均膝关节屈伸活动度分为别为137.1°±9.0°和135.6°±12.1°,组间差异均无统计学意义(>0.05)。结论胫骨髁间棘骨折采用关节镜下空心螺钉或缝合线固定均可确定满意的临床疗效,患者术后2年的功能效果良好。Objective To explore The comparison between arthroscopic cannulated screw and suture fixation on tibial spine fractures curative effect and functional effects. Methods Retrospective analysis of 28 patients＇ information accepted arthroscopic fixation of the fracture due to tibial spine fractures, depending on the surgical fixation methods, The patients were divided into two groups of A, B. Patients were received arthroscopic cannulated screw fixation in A group and ar- throscopic suture fixation in B group. Conduct the investigations of the perioperative indicators of the patients＇ surgical time, tourniquet application. At the last follow-up, assessed the knee function effects with the anterior drawer test, Lachman test, the Hospital for Special Surgery score （Hospital for Special Surgery, HSS） and the Lysholm score. Results 23 patients with clinical and radiologic follow-up for 24 months, 13 patients in group A and 10 cases in group B. Group A and group B Operation time were （180.3± 12.7） minand （176.2± 11.4） rain, Tourniquet application times are （113.7 ± 10.4） min and （111.6 ±10.0） min respectively. The difference between the groups was not statistically significant （2＇〉0.05）. All patients were bone union and not displaced fractures. At the last follow-up, the ipsilateral knee anterior drawer test and Lachman test were negative; average HSS score of A, B two groups were 95.0±2.9 and 96.8±2.4, mean Lysholm score were 94.2 ±2.1 and 93.8 ± 1.9, average knee range of motion were 137.1 °± 9.0° and 135.6° ±12.1 °, the difference between the groups was not statistically significant （P〉0.05）. Conclusion Both tibial spine fracture with arthroscopic cannulated screw and suture fixation can determine a satisfactory clinical efficacy, and 2 years after surgery in patients with good functional outcomes.

关 键 词：胫骨髁间棘骨折 关节镜 空心螺钉 缝线固定 

分 类 号：R687.3[医药卫生—骨科学]