铆钉辅助空心钉治疗后交叉韧带止点撕脱性骨折的病例对照研究  

Treatment of posterior cruciate ligament avulsion fracture with rivet-assisted hollow nail:a case-control study

作　　者：朱佳福[1] 马苟平[1] 徐卫星[1] 郭峭峰[1] 刘宏[1] ZHU Jia-fu MA Gou-ping XU Wei-xing GUO Qiao-feng LIU Hong(Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China)

机构地区：[1]浙江省立同德医院骨科,浙江杭州310012

出　　处：《中国骨伤》2017年第4期334-338,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :回顾性探讨铆钉辅助空心钉治疗后交叉韧带止点撕脱性骨折的临床疗效。方法 :收集2010年1月至2014年12月收治49例膝后交叉韧带止点撕脱性骨折的临床资料,分为治疗组和对照组。治疗组31例,采用铆钉辅助双枚空心钉治疗,其中男14例,女17例;年龄38~51岁,平均(40.6±5.1)岁;Meyers 2型23例,Meyers 3型8例;低能量损伤5例,高能量损伤26例。对照组18例,采用双枚空心钉治疗,其中男9例,女19例;年龄36~52岁,平均(41.6±4.7)岁;Meyers 2型14例,Meyers 3型4例;低能量损伤2例,高能量损伤16例。对两组患者的手术时间、术后并发症、骨折愈合时间及术后末次的AKS评分进行对比。结果:49例均获随访,时间12~24个月,平均14.2个月。治疗组患者术后未出现骨折块移位及内固定失败;AKS评分系统中疼痛48.1±1.5,活动度21.3±2.7,稳定性20.9±2.5,行走能力47.3±1.9,上下楼梯能力43.4±2.1,总分190.7±2.9。对照组2例术后出现骨折块移位,1例出现退钉;AKS评分中疼痛40.1±2.2,活动度20.1±0.2,稳定性18.1±3.2,行走能力46.3±1.7,上下楼梯能力40.2±1.3,总分180.2±1.4。以上指标比较,治疗组均优于对照组。结论:铆钉辅助空心钉治疗后交叉韧带止点撕脱性骨折,具有复位确切、术后并发症少、术后膝关节功能恢复效果更好等优点,是治疗后交叉韧带止点撕脱性骨折的有效办法。Objective：To retrospectively investigate the clinical effect of the rivet-assisted hollow screw in the treatment of posterior cruciate ligament avulsion fracture.Methods：Total 49 patients with knee cruciate ligament avulsion fracture in the ending point of the ligament from January 2010 to December 2014 were divided into the treatment group and the control group.Thirty-one patients in treatment group were treated with rivet-assisted double cannulate nail,including 13 males and 18 females,ranging in age from 38 to 51 years old,with a mean of（40.6±5.1） years old;according to Meyers classification,23 cases of type 2,8 cases of type 3;5 patients were caused by the low energy injury and 26 patients were caused by the high energy injury.Eighteen patients in control group were treated with double gold hollow screw fixation,including 5 males and 13 females,ranging in age from 36 to 52 years old,with an average age of（4.16±4.7） years old;according to Meyers classification,14 cases of type 2 and 4 cases of type 3;2 patients were caused by the low energy injury and 16 patients were caused by the high energy injury.The operation time,postoperative complications,fracture healing time and the last AKS scoring system were compared between the two groups.Results：All the patients were followed up,and the duration ranged from 12 to 24 months,with an average of 14.2 months.The patients in treatment group had no displacement of fracture fragments and internal fixation failure.The results of AKS score：pain was 48.1 ±1.5,activity was 21.3±2.7,stability was 20.9±2.5,walking ability was 47.3±1.9,under the stairs ability was 43.4±2.1,the total score was 190.7±2.9.There were 2 cases in control group had fracture fragment displacement and 1 patient had nail withdraw.The results of AKS score：pain was 40.1±2.2,activity was 20.1 ±0.2,stability was 18.1±3.2,walking ability was 46.3±1.7,under the stairs ability was 40.2 ±1.3,the total score was 180.2±1.4.Therefore,the comparison of the above indicators,the result

关 键 词：骨折固定术 内 后交叉韧带 膝关节 病例对照研究 

分 类 号：R686.5[医药卫生—骨科学]