关节镜下钢丝固定与栓桩缝线固定术治疗前交叉韧带胫骨止点撕脱骨折的疗效对比  

Efficacy of bolt post suture fixation versus steel wire fixation under arthroscopy in the treatment of avulsion fracture of tibial insertion of anterior cruciate ligament

作　　者：吕向阳 王丛 王志超 徐振卫 LV Xiang-yang;WANG Cong;WANG Zhi-chao;XU Zhen-wei(Department of Orthopedics,Xi'an Qinhuang Hospital,Xi'an 710000,Shaanxi,CHINA;Department of Orthopedics,Heilongjiang Provincial Hospital Affiliated to Harbin Institute of Technology,Harbin 150000,Heilongjiang,CHINA;Department of Orthopedics,Harbin Fifth Hospital,Harbin 150000,Heilongjiang,CHINA;Department of Orthopedics,Xi'an International Medical Center Hospital,Xi'an 710000,Shaanxi,CHINA)

机构地区：[1]西安秦皇医院骨科,陕西西安710000 [2]哈尔滨工业大学附属黑龙江省医院骨科,黑龙江哈尔滨150000 [3]哈尔滨市第五医院骨科,黑龙江哈尔滨150000 [4]西安国际医学中心医院骨科,陕西西安710000

出　　处：《海南医学》2022年第23期3034-3038,共5页Hainan Medical Journal

摘　　要：目的比较关节镜下钢丝固定与栓桩缝线固定术治疗前交叉韧带(ACL)胫骨止点撕脱骨折的疗效。方法选择2019年10月至2021年2月西安秦皇医院骨科和西安国际医学中心医院收治的100例ACL胫骨止点撕脱骨折患者为研究对象,采用随机数表法均分为对照组和观察组各50例。对照组患者给予关节镜下钢丝内固定术治疗,观察组患者给予关节镜下栓桩缝线固定术治疗。比较两组患者的手术情况,以及术前、术后6个月的国际膝关节文献委员会(IKDC)评分、Lysholm评分及SF-36健康调查简表(SF-36)评分,同时比较两组患者术后并发症发生情况。结果观察组患者的手术时间、骨折愈合时间、住院时间及术后引流量分别为(55.93±5.29)min、(4.58±0.63)个月、(8.98±2.12)d、(98.41±7.34)mL,均明显短(低)于对照组的(67.91±5.88)min、(4.91±0.49)个月、(10.38±2.01)d、(112.35±8.39)mL,差异均有统计学意义(P<0.05);术后6个月,两组患者的IKDC、Lysholm评分均升高,且观察组患者的IKDC、Lysholm评分分别为(88.41±7.29)分、(85.13±7.28)分,明显高于对照组的(74.45±8.26)分、(72.19±9.34)分,差异均有统计学意义(P<0.05);术后6个月,两组患者的物质生活、社会功能、躯体功能、心理功能等评分均升高,且观察组患者的上述各项评分分别为(69.21±7.23)分、(71.93±7.23)分、(78.13±4.99)分、(78.34±6.23)分,明显高于对照组的(60.72±6.11)分、(61.24±8.02)分、(69.14±6.98)分、(67.39±7.28)分,差异均有统计学意义(P<0.05);观察组患者术后的总并发症发生率为6.00%,明显低于对照组的20.00%,差异有统计学意义(P<0.05)。结论关节镜下栓桩缝线固定术治疗ACL胫骨止点撕脱骨折损伤小,可促进膝关节功能恢复,提高生活质量,且并发症少,值得临床推荐使用。Objective To compare the efficacy of steel wire fixation and bolt post suture fixation under arthroscope in the treatment of avulsion fracture of tibial insertion of anterior cruciate ligament(ACL).Methods A total of 100 patients with avulsion fracture of ACL tibial insertion point admitted to the Department of Orthopaedics,Xi'an Qinhuang Hospital and Xi'an International Medical Center Hospital from October 2019 to February 2021 were selected as the study objects.They were divided into the control group and the observation group by random number table method,with 50 cases patients in each group.The patients in the control group were treated with steel wire internal fixation under arthroscopy,and the patients in the observation group were treated with bolt post suture fixation under arthroscopy.The operation conditions of the two groups were compared,as well as the International Knee Documentation Committee(IKDC)knee evaluation form score,Lysholm score,the MOS 36-Item Short-Form Health Survey(SF-36)score before and 6 months after operation,and the postoperative complications.Results The operation time,fracture healing time,length of hospital stay,and postoperative drainage volume in the observation group were(55.93±5.29)min,(4.58±0.63)months,(8.98±2.12)d,(98.41±7.34)mL,which were significantly shorter(lower)than(67.91±5.88)min,(4.91±0.49)months,(10.38±2.01)d,(112.35±8.39)mL in the control group(P<0.05).Six months after operation,the IKDC and Lysholm scores of the two groups increased,and scores of the observation group were(88.41±7.29)points and(85.13±7.28)points,which were significantly higher than(74.45±8.26)points and(72.19±9.34)points of the control group,with statistically significant differences(P<0.05).Six months after operation,the scores of material life,social function,physical function,and psychological function of patients in the two groups increased,and the above scores in the observation group were(69.21±7.23)points,(71.93±7.23)points,(78.13±4.99)points,(78.34±6.23)points,which were s

关 键 词：前交叉韧带胫骨止点撕脱骨折 关节镜 钢丝固定 栓桩缝线固定 膝关节功能 生活质量 并发症 

分 类 号：R683.42[医药卫生—骨科学]