关节镜下三点双“8”字联合外排锚钉固定与空心螺钉固定治疗成人胫骨髁间嵴骨折的疗效比较  

Comparative analysis of arthroscopic cannuiated screw and three-point double "8" combined with PushLock anchor in the fixation of adult tibial eminentia avulsion fracture

作　　者：田进翔 杨东强[1] 崔红林 马炜 刘一军 付鹏飞 郭标[1] TIAN Jinxiang;YANG Dongqiang;CUI Honglin;MAWei;LIU Yijun;FU Pengfei;GUO Biao(Department of Orthopaedics Surgery,Fuyang People's Hospital Affiliated to Anhui Medical University,Fuyang Hospital Affiliated to Bengbu Medical College,Fuyang 236000,Anhui,China)

机构地区：[1]安徽医科大学附属阜阳人民医院蚌埠医学院附属阜阳医院骨科,安徽阜阳236000

出　　处：《中华骨与关节外科杂志》2022年第7期532-537,共6页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:比较关节镜下三点双“8”字联合外排锚钉固定与空心螺钉固定治疗成人胫骨髁间嵴骨折的临床疗效。方法:回顾性分析2015年2月至2021年7月收治的43例胫骨髁间嵴骨折患者,包括Meyers-McKeeverⅡ型22例,Ⅲ型21例。其中24例患者采用关节镜下三点双“8”字缝合联合外排锚钉固定(缝线固定组),19例患者采用关节镜下空心螺钉固定(空心螺钉固定组)。术前及术后6个月通过膝关节Lysholm评分比较两组患者膝关节功能。术后6个月通过前抽屉试验、Lachman试验比较两组患者膝关节稳定性。结果:43例患者均获得随访,缝线固定组随访时间6~24个月,平均随访(11.4±3.6)个月,空心螺钉固定组随访时间12~23个月,平均随访(15.2±2.2)个月。术后3个月影像学检查提示骨折均愈合。术后6个月,两组患者Lysholm评分均较术前改善(P<0.05),两组患者间比较膝关节Lysholm评分及前抽屉试验、Lachman试验结果差异均无统计学意义(P均>0.05)。结论:对于Meyers-McKeeverⅡ型及Ⅲ型胫骨髁间嵴骨折,关节镜下三点双“8”字缝合联合外排锚钉固定与关节镜下空心螺钉固定临床疗效相当,均可达到有效复位固定骨折块,获得良好的膝关节功能。Objective: To compare the clinical effect of arthroscopic three-point double "8" combined with PushLock anchor fixation and cannuiated screw fixation in treatment of tibial eminentia avulsion fracture under arthroscope. Methods: A total of 43 patients with tibial eminentia avulsion fracture(Meyers-McKeever classification, 22 cases of type Ⅱ and 21 cases of type Ⅲ) admitted to our hospital from February 2015 to July 2021 were analyzed retrospectively. Of them, under arthroscope, 24 patients were treated with three-point double "8" suture combined with PushLock anchor(suture fixation group), and 19 patients were fixed with cannuiated screw(cannuiated screw fixation group). The knee function of the two groups was compared by knee Lysholm score before operation and 6 months after operation. The knee stability of the two groups was compared by anterior drawer test and Lachman test 6 months after operation. Results: The mean duration of follow-up was(11.4±3.6) months(range, 6-24 months) in the suture fixation group and(15.2±2.2) months(range, 12-23 months) in the cannuiated screw fixation group. Radiographic examination showed bone union within three months. The Lysholm score of the two groups at 6 months after operation was significantly higher than that before operation(P<0.05).There was no significant difference in the Lysholm score, front drawer test results or Lachman test between the two groups at 6 months after operation(P>0.05). Conclusions: For Meyers-McKeever type Ⅱ and Ⅲ tibial eminentia avulsion fracture, both arthroscopic three-point double "8" suture combined with PushLock anchor fixation and arthroscopic cannulated screw fixation can achieve effective reduction and fixation of the fracture block and obtain good knee function.

关 键 词：关节镜 胫骨髁间嵴骨折 缝线桥 空心螺钉 

分 类 号：R683.4[医药卫生—骨科学]