膝后内小切口联合关节镜下高强线双SMC结固定治疗后交叉韧带撕脱骨折的临床效果  

Clinical efficacy of posterior medial mini-incision combined with arthroscopic double SMC knot fixation using high-strength suture in treatment of posterior cruciate ligament avulsion fractures

作　　者：唐金山 俞淮曦 TANG Jinshan;YU Huaixi(Department of Orthopedics,Huai′an Hospital Affiliated to Xuzhou Medical University,Huai′an,Jiangsu,223002)

机构地区：[1]徐州医科大学附属淮安医院骨科,江苏淮安223002

出　　处：《实用临床医药杂志》2024年第21期95-99,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省卫生健康委科研项目(BK20221653)。

摘　　要：目的分析膝后内小切口联合关节镜下高强线双SMC结固定治疗后交叉韧带(PCL)撕脱骨折的效果。方法选取60例PCL撕脱骨折患者为研究对象,随机分为锚钉固定组(锚钉固定,n=30)和高强线固定组(高强线双SMC结固定,n=30)。记录2组随访情况。比较2组的骨折愈合时间、手术时间以及治疗前后的膝关节功能Lysholm评分、国际膝关节文献委员会(IKDC)评分和膝关节活动度变化。结果60例患者随访时间为6.5~22.5个月,平均(13.50±7.49)个月,未有失访患者。2组均有4例患者抽屉试验弱阳性,但无伸膝受限情况。2组术后Lysholm评分、IKDC评分、膝关节活动度比较,差异无统计学意义(P>0.05)。高强线固定组的骨折愈合时间、手术时间分别为(11.27±0.87)周、(53.73±4.67)min,短于锚钉固定组的(12.35±1.03)周、(64.06±5.13)min,差异有统计学意义(P<0.05)。结论膝后内小切口联合关节镜下高强线双SMC结固定或锚钉固定治疗PCL撕脱骨折患者的效果均较好,但高强线双SMC结固定的手术时间、骨折愈合时间更短,操作难度更低。Objective To analyze the efficacy of posterior medial mini-incision combined with arthroscopic double SMC knot fixation using high-strength suture in the treatment of posterior cruciate ligament(PCL)avulsion fractures.Methods Sixty patients with PCL avulsion fractures were selected as the study subjects,and randomly divided into anchor fixation group(treated with anchor fixation,n=30)and high-strength suture fixation group(treated with double SMC knot fixation using high-strength suture,n=30).Follow-up data were recorded for both groups.The fracture healing time,operative time,as well as changes in knee function assessed by the Lysholm score,International Knee Documentation Committee(IKDC)score and knee range of motion before and after treatment were compared between the two groups.Results The follow-up period for all 60 patients ranged from 6.5 to 22.5 months,with a mean time of(13.50±7.49)months.No patients were lost during follow-up.Four patients in each group showed a weakly positive drawer test,but no restrictions in knee extension were observed.There were no statistically significant differences in postoperative Lysholm scores,IKDC scores and knee range of motion between the two groups(P>0.05).The fracture healing time and operative time in the high-strength suture fixation group were(11.27±0.87)weeks and(53.73±4.67)minutes,respectively,which were significantly shorter than(12.35±1.03)weeks and(64.06±5.13)minutes in the anchor fixation group(P<0.05).Conclusion Both posterior medial mini-incision combined with arthroscopic double SMC knot fixation using high-strength suture or anchor fixation are effective in treating PCL avulsion fractures.However,the high-strength suture double SMC knot fixation method exhibits shorter operative time and fracture healing time,as well as lower operative difficulty.

关 键 词：膝后内小切口 关节镜 后交叉韧带 胫骨止点撕脱骨折 锚钉固定 

分 类 号：R816.8[医药卫生—放射医学] R683[医药卫生—临床医学] R319