关节镜下空心螺钉与带袢钛板治疗前交叉韧带胫骨止点骨折疗效观察  

The Effect of Hollow Screw and Loop Titanium Plate in the Treatment of Tibial Insertion Fracture of Anterior Cruciate Ligament(ACL)Under Arthroscopy

作　　者：黎太友 曹鹏 杨波 张丽红 吴沛冉 郭俊杰 范圣益 李开春 董玮[2] LI Taiyou;CAO Peng;YANG Bo;ZHANG Lihong;WU Peiran;GUO Junjie;FAN Shengyi;LI Kaichun;DONG Wei(Qujing Hospital of Traditional Chinese Medicine)

机构地区：[1]曲靖市中医医院,云南曲靖655099 [2]昆明市中医医院 [3]勐海县中医医院

出　　处：《长治医学院学报》2023年第6期426-430,共5页Journal of Changzhi Medical College

基　　金：云南省中医(骨伤)临床医学中心建设项目(20210701)。

摘　　要：目的:探讨关节镜监视下空心螺钉与带袢钛板治疗前交叉韧带(ACL)胫骨止点骨折的近期临床疗效。方法:回顾性分析27例前交叉韧带胫骨止点撕脱性骨折患者临床资料,按照手术方式将其分为2组,A组(13例)采用关节镜监视下空心螺钉固定,B组(14例)采用关节镜监视下高强线联合带袢钛板固定。比较2组患者住院时间、手术时间、骨折愈合时间、术后3个月膝关节活动度、膝关节疼痛视觉模拟评分(VAS)、膝关节Lysholm评分等。结果:A组住院时间短于B组,但差异无统计学意义(P>0.05);A组手术时间短于B组(P<0.05);B组骨折愈合时间短于A组(P<0.05);B组术后3个月膝关节活动度明显优于A组(P<0.05);2组患者术后1个月VAS评分比较,B组明显优于A组(P<0.05),术后2个月、3个月VAS评分比较2组差异无统计学意义(P>0.05);术后1个月、2个月Lysholm评分比较,B组均优于A组,差异有统计学意义(P<0.05),2组术后3个月比较差异无统计学意义(P>0.05)。结论:关节镜监视下空心螺钉固定与带袢钛板固定治疗ACL胫骨止点骨折均可达到不错的疗效,但在早期疼痛缓解、功能恢复、骨折愈合方面,带袢钛板表现更为优异,且带袢钛板可避免二次手术取出内固定物。Objective:To investigate the effectiveness of hollow screw and loop titanium plate in the treatment of tibial insertion fracture of the anterior cruciate ligament(ACL)under arthroscopy.Methods:A total of 27 patients with tibial eminence avulsion fracture of anterior cruciate ligament were retrospectively analyzed.According to the operation method,they were divided into 2 groups.Group A was fixed with hollow screws under arthroscopy,and group B was fixed with high-intensity sutures combined with loop titanium plates under arthroscopy.The hospitalization time,operation time,fracture healing time,knee range of motion(ROM),Visual Analogue Scale(VAS)and Lysholm score were compared between the two groups 3 months after the operation.Results:The length of hospital stay in group A was shorter than that in group B,but the difference was not statistically significant(P>0.05).The operation time of group A was significantly shorter than that of group B(P<0.05).The fracture healing time of group B was shorter than that of group A,and the difference was statistically significant(P<0.05).The knee range of motion in group B was significantly better than that in group A at 3 months after operation,and the difference was statistically significant(P<0.05).There was no significant difference in VAS and Lysholm scores between the two groups before operation(P>0.05).The VAS score of group B was significantly better than that of group A 1 month after the operation,and the difference was statistically significant(P<0.05).There was no significant difference in VAS scores between the two groups at 2 and 3 months after the operation(P>0.05).The Lysholm score of group B was significantly better than that of group A after the operation and 2 months after the operation(P<0.05),but there was no significant difference between the two groups at 3 months after the operation(P>0.05).Conclusion:Both hollow screw fixation and loop titanium plate fixation under arthroscopy can achieve good effectiveness in the treatment of ACL tibial insertion fractu

关 键 词：膝关节镜 带袢钛板 空心螺钉 前交叉韧带 胫骨止点骨折 

分 类 号：R683.42[医药卫生—骨科学]