关节镜下空心螺钉与不可吸收缝线固定治疗儿童胫骨髁间嵴骨折的疗效对比  

Clinical outcomes of screw fixation and suture fixation in the treatment of tibial eminence fractures in pediatric patients

作　　者：李浩[1] 李海[1] 沙霖 张自明[1] Li Hao;Li Hai;Sha Lin;Zhang Ziming(Department of Pediatric Orthopedics,Affiliated Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院儿骨科,上海市200092

出　　处：《临床小儿外科杂志》2021年第5期453-457,共5页Journal of Clinical Pediatric Surgery

基　　金：上海交通大学医工交叉研究基金(编号:YG2021 QN44)。

摘　　要：目的比较关节镜下使用空心螺钉及不可吸收缝线固定治疗儿童胫骨髁间嵴骨折的临床疗效。方法以上海交通大学医学院附属新华医院2015年7月至2018年2月收治并行手术治疗的22例胫骨髁间嵴骨折患者为研究对象,其中Meyers-McKeeverⅡ型7例,Ⅲ型13例,ZaricznyjⅣ型2例。术前均行双侧膝关节X线、CT检查。根据使用内固定材料的不同分为不可吸收缝线组(8例)和空心螺钉组(14例)。随访时进行Lysholm评分、关节活动度及Lachman试验等以评估疗效。结果22例随访12~30个月,平均随访23个月。螺钉组Lyshlom评分(93±4.6)分,优7例,良6例,差1例;缝线组Lyshlom评分(91±5.8)分,优2例,良5例,差1例;两组评分差异无统计学意义(t=0.18,P=0.70);关节活动度异常缝线组2例,螺钉组1例。螺钉组Lachman试验Ⅱ度1例。空心螺钉组的平均手术时间短于不可吸收缝线组,差异有统计学意义(P<0.05)。结论关节镜下空心螺钉及不可吸收缝线固定治疗儿童胫骨髁间嵴骨折临床疗效均满意,且无显著差异。关节镜下螺钉固定手术时间更短,操作更简单,但需二次手术取出螺钉。Objective To compare the clinical outcomes of arthroscopic reduction and internal fixation(ARIF)with cannulated screw versus nonabsorbable suture in the treatment of tibial eminence fractures in children.Methods A retrospective study was performed for 22 children with tibial eminence fractures.Based upon the Meyers-McKeever s classification scheme,there were typeⅠ(n=0),typeⅡ(n=7),typeⅢ(n=13)and Zaricznyj typeⅣ(n=2).They underwent bilateral knee joint radiography and computed tomography(CT)pre-operation.According to the internal fixation materials,they were divided into two groups of nonabsorbable suture(n=8)and cannulated screw(n=14).Lysholm score,range of motion and Lachman test were recorded.Results The mean follow-up period was 23(12-30)months.No significant inter-group difference existed in Lysholm score(P>0.05).The average operative duration was shorter in cannulated screw group than that in nonabsorbable suture group(P<0.05).Conclusion Both cannulated screw and nonabsorbable suture are effective internal fixation options for tibial eminence fractures in children.And the operative duration of cannulated screw group is shorter.However,cannulated screw should be removed by re-operation.

关 键 词：胫骨骨折/外科学 关节镜检查/方法 缝线/方法 骨折固定术/方法 疗效比较研究 儿童 

分 类 号：R683.42[医药卫生—骨科学] R684[医药卫生—外科学]