空心钉结合锚钉与空心钉单独固定治疗胫骨后交叉韧带止点撕脱骨折对比研究  

A comparative study on the treatment of avulsion fractures of the posterior cruciate ligament of tibia with hollow nails combined with anchor nails and hollow nails alone

作　　者：吴冯胜[1] 徐执扬[1] 李晗[1] 吴飞华[1] 苏新杰[1] 梁喜斌[1] 陈蕾 Wu Fengsheng;Xu Zhiyang;Li Han;Wu Feihua;Su Xinjie;Liang Xibin;Chen Lei(Department of Orthopaedics,Beijing ChuiYangLiu Hospital,Beijing 100022,China)

机构地区：[1]北京市垂杨柳医院骨科,北京100022

出　　处：《创伤外科杂志》2021年第8期572-575,共4页Journal of Traumatic Surgery

基　　金：首都卫生发展科研专项(首发2014-3-7031)。

摘　　要：目的比较空心钉结合锚钉与空心钉单独固定治疗胫骨后交叉韧带(PCL)止点撕脱骨折的临床疗效。方法回顾性分析2016年1月—2020年1月在北京市垂杨柳医院骨科接受诊治的28例胫骨PCL止点撕脱骨折患者的临床资料。行膝关节后内侧入路空心钉结合锚钉固定治疗的14例患者设为观察组,男性7例,女性7例;年龄20~65岁,平均33.8岁;运动损伤4例,道路交通伤10例。行膝关节后内侧入路空心钉治疗的14例患者设为对照组,男性8例,女性6例;年龄20~65岁,平均34.7岁;运动损伤3例,道路交通伤11例。比较两组手术指标、膝关节各功能、关节渗液、下肢静脉血栓、螺钉与锚钉松动等并发症发生情况。结果术后9个月,两组美国膝关节协会(AKS)评分及Lysholm评分均明显高于术前,且观察组明显高于对照组(191.24±2.29)分vs.(181.26±1.56)分,P<0.05;(92.28±3.29)分vs.(88.02±3.32)分,P<0.05。两组手术时间、术中出血量以及骨折愈合时间比较差异无统计学意义(P>0.05)。观察组并发症发生率明显低于对照组(0 vs.14.29%,P<0.05)。结论采用膝关节后内侧入路空心钉结合锚钉固定治疗的手术方式,可有效提高胫骨PCL止点撕脱骨折患者术后患肢膝关节功能,减少术后并发症发生,且未延长手术时间及骨折愈合时间。Objective To explore the clinical effect of hollow nails combined with anchor nails and hollow nails alone for the treatment of posterior cruciate ligament(PCL)avulsion fractures of the tibia.Methods The clinical data of 28 patients with PCL avulsion fractures of the tibia who were diagnosed and treated in the Department of Orthopedics of Beijing Chui Yang Liu Hospital from Jan.2016 to Jan.2020 were retrospectively analyzed.Fourteen patients treated with hollow nails and anchors via posterior medial approach of the knee joint were set as the observation group,including 7 males and 7 females,with an average of 33.8 years(range,20-65 years);4 cases were sports injuries and 10 cases were traffic accident injuries.Fourteen patients who underwent the posterior medial approach hollow nail treatment were set as the control group,including 8 males and 6 females,with an average of 34.7 years(range,20-65 years);3 cases were sports injuries and 11 cases were traffic accident injuries.The surgical indicators,knee joint functions,and complications such as joint exudate,lower extremity venous thrombosis,screw and anchor loosening were compared between the two groups.Results After 9 months of treatment,the AKS scores and Lysholm scores of the two groups were significantly higher than those before operation,and the observation group were significantly higher than those in the control group[(191.24±2.29)points vs.(181.26±1.56)points;(92.28±3.29)points vs.(88.02±3.32)points,P<0.05].There was no significant difference in operation time,blood loss and fracture healing time between the two groups(P>0.05).The incidence of complications in the observation group was significantly lower than that in the control group(0 vs.14.29%,P<0.05).Conclusion The surgical method of hollow nails combined with anchor fixation via posterior medial approach of the knee joint can effectively improve the knee joint function of the affected limb in patients with PCL avulsion fractures after surgery,reduce postoperative complications,and does not increa

关 键 词：韧带损伤 撕脱骨折 空心钉 锚钉 入路 

分 类 号：R686[医药卫生—骨科学]