双重张力带钢丝和空心拉力螺钉治疗青少年胫骨结节撕脱骨折的疗效比较  

Comparison of therapeutic effects between double tension band steel wire and hollow tension screw in the treatment of tibial tubercle avulsion fractures in adolescents

作　　者：刘志成 王升英[1] 王英华[1] LIU Zhi-cheng;WANG Sheng-ying;WANG Ying-hua(Department of Osteoarthritis and Sports Medicine,Qingdao Municipal Hospital,Qingdao,Shandong,266000,China)

机构地区：[1]青岛市市立医院骨关节与运动医学科,山东省266000

出　　处：《中国骨与关节杂志》2024年第3期179-183,共5页Chinese Journal of Bone and Joint

摘　　要：目的 比较双重张力带钢丝和空心拉力螺钉治疗青少年胫骨结节撕脱骨折临床疗效。方法回顾分析2019年7月至2022年12月于我院就诊的36例胫骨结节撕脱骨折患者的临床资料,根据治疗方法不同分为两组:试验组15例,采用双重张力带钢丝固定;对照组21例,采用空心拉力螺钉固定。术后定期骨科门诊对患者进行随访,记录患者患膝可耐受负重、屈曲达到120°、完全活动范围、活动不受限制所需时间。随访时记录切口感染、内固定物刺激、膝关节内外翻、双下肢不等长等并发症。术后即刻、术后1个月及6个月,复查膝关节正、侧位X线片评估骨折愈合情况。结果 试验组与对照组患者年龄、性别、侧别、体质量指数、随访时间、受伤至手术时间等术前一般资料比较差异均无统计学意义(P> 0.05)。试验组患者平均开始负重时间(4.87±1.13)周,所需时间早于对照组(6.10±1.51)周,差异有统计学意义(P <0.05);术后活动度方面,试验组平均(10.67±3.11)周恢复膝关节屈曲120°,(13.47±2.20)周恢复完全活动度,所需时间均少于对照组(13.24±3.36)周、(15.62±2.89)周,差异有统计学意义(P <0.05);术后恢复正常,活动不受限制,试验组平均需要(17.80±2.21)周,对照组平均需要(20.57±2.56)周,两组之间差异有统计学意义(P <0.05)。术后随访两组患者均未发生并发症。结论 双重张力带钢丝与空心拉力螺钉固定青少年胫骨结节撕脱骨折均确定有效,双重张力带固定骨折更稳定,可以促使患者早期进行康复功能锻炼,进而恢复膝关节功能,使患者早日恢复正常活动、回归生活。Objective To compare the clinical efficacy of double tension band steel wire with hollow tension screw in the treatment of tibial tubercle avulsion fractures in adolescents.Methods A retrospective analysis was conducted on the clinical data of 36 patients with tibial tubercle avulsion fractures who visited our hospital from July 2019 to December 2022.They were divided into two groups based on different treatment methods.The experimental group consisted of 15 patients who were fixed with double tension band steel wire.The control group of 21 cases was fixed with hollow tension screws.Regular follow-up visits will be conducted at the orthopedic clinic after surgery to record the time required for the patient’s knee to tolerate weight bearing,flexion to 120°,complete range of motion,and unrestricted mobility.During follow-up,complications such as incision infection,internal fixation stimulation,knee joint varus and varus,and unequal length of both lower limbs were recorded.AP and lateral X-ray films of the knee joint immediately after surgery,1 month and 6 months after surgery were checked to evaluate the fracture healing status.Results There was no statistically significant difference in preoperative general information such as age,gender,body mass index,follow-up time,and time from injury to surgery between the experimental group and the control group(P>0.05).The average starting weight bearing time of the experimental group(4.87±1.13 weeks)and the required time(6.10±1.51 weeks)were earlier than that of the control group with statistically significant differences(P<0.05).Progress in postoperative mobility was observed in the experimental group,with an average recovery of 120°knee flexion at(10.67±3.11)weeks and complete mobility at(13.47±2.20)weeks.The time required for recovery was shorter than that of the control group(13.24±3.36)weeks and(15.62±2.89)weeks,with statistically significant differences(P<0.05).The postoperative recovery was normal,with unrestricted activity.The experimental group took an a

关 键 词：青少年 骨折固定术 内 胫骨骨折 膝关节活动度 早期康复功能锻炼 

分 类 号：R683.4[医药卫生—骨科学]