比较可吸收带线锚钉与缝线套扎治疗胫骨髁间嵴骨折  

Comparison of absorbable wire anchors and suture sleeve ligation for avulsion fractures of tibial intercondylar ridge

作　　者：曹万军 白笋蓬 Cao Wanjun;Bai Sunpeng(Department of Orthopedics, The First People′s Hospital of Tianmen, Tianmen 431700, China)

机构地区：[1]天门市第一人民医骨科,431700

出　　处：《中华关节外科杂志（电子版）》2021年第3期379-382,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的比较可吸收带线锚钉与缝线套扎治疗胫骨髁间嵴骨折的异同。方法通过随机数字表法,将2018年1月至2019年5月湖北省天门市第一人民医院骨科收治的符合纳入、排除条件的胫骨髁间嵴骨折患者,随机分为带线锚钉组(采用可吸收带线锚钉治疗)、缝线套扎组(采用缝线套扎法治疗)。用t检验或卡方检验比较两组患者的一般情况、手术时间、手术出血量、骨折愈合时间,及膝关节相关功能指标:国际膝关节文献委员会(IKDC)膝关节韧带标准评估、Lysholm评分、疼痛视觉模拟评分(VAS)。结果两组患者年龄(t=0.409)、性别(χ^(2)=0.023)、骨折原因(χ^(2)=0.195)、Meyers-Mckeever骨折分型(χ^(2)=1.653)及受伤肢体(χ^(2)=0.820)等一般资料基本一致(均为P>0.05)。带线锚钉组的手术时间(t=4.943)及骨折愈合时间(t=20.370)较缝线套扎组明显缩短、且术中出血量(t=5.291)更少(均为P<0.05)。两组患者术前的Lysholm评分(t=0.374)、IKDC 2000(t=0.803)、VAS评分(t=0.063)比较差异无统计学意义(P>0.05);术后6个月,2组的Lysholm评分(t=0.381)、IKDC 2000评分(t=0.423)、VAS评分(t=0.421)相比亦较一致(均为P>0.05)。结论使用可吸收带线锚钉与缝线套扎均可促进胫骨髁间嵴骨折患者膝关节功能的恢复,但关节镜下使用可吸收带线锚钉能缩短手术时间和骨折愈合时间,能减少手术出血量。Objective To compare the similarities and differences of two modalities,absorbable suture anchors and suture sleeve ligation,for the treatment of tibial intercondylar ridge fractures.MethodsUsing the random number table method,eligible included and excluded tibialintercondylar crest fracture patients were treated in the department of orthopedics,the First People′s Hospital of Tianmen,from January 2018 to May 2019 were randomly divided into two groups:the wire anchor group(treated by absorbable suture anchor),and the suture cuff group(treated by suture cuff).The data were analyzed with t test or chi-square test to compare the general conditions,operative time,operative blood loss,fracture healing time,and other knee related functional indicators between the two groups,such as International Knee Documentation Committee(IKDC)score,Lysholm score,and visual analogue scale(VAS).Results Age(t=0.409),gender(χ^(2)=0.023),fracture cause(χ^(2)=0.195),Meyers-McKeever fractures classification(χ^(2)=1.653),injured side(χ^(2)=0.820)and other general data were generally consistent(all P>0.05).The surgical time(t=4.943)and fracture healing time(t=20.370)in the group with suture anchors were significantly shorter,and the intraoperative blood loss(t=5.291)was less than those in the suture sleeve ligation group,with statistically significant differences(all P<0.05).The differences of Lysholm score(t=0.374),IKDC 2000 score(t=0.803),and VAS scores(t=0.063)preoperatively between the two groups were not significantly different(all P>0.05).At six months postoperatively,the Lysholm score(t=0.381),IKDC 2000 score(t=0.423),and VAS scores(t=0.421)of the two groups were also consistent(all P>0.05).Conclusion The use of absorbable wire anchors and suture sleeve ligation can both promote the recovery of knee function in the patients with tibial intercondylar crest fractures,but the former one may reduce operative time,the fracture healing time and the operative blood loss.

关 键 词：前交叉韧带 骨折 撕脱性 关节内骨折 

分 类 号：R68[医药卫生—骨科学]