关节镜下两种固定方式治疗前交叉韧带胫骨止点撕脱骨折的临床研究

目的探讨关节镜下螺钉与缝线固定治疗前交叉韧带(ACL)胫骨止点撕脱骨折临床疗效差异。方法研究对象选取ACL胫骨止点撕脱骨折患者共80例,以随机数字表法分为A组(40例)和B组(40例),分别在关节镜下行缝线与螺钉固定治疗;比较两组患者手术时间、随访Lysholm膝关节评分、国际膝关节评分委员会(IKDC)膝关节功能主观量表评分、患健侧位移差值及屈曲挛缩发生率。结果 B组患者手术时间明显短于A组(P0.05);两组患者随访Lysholm评分、IKDC评分及患健侧位移差值比较差异无统计学意义(P0.05);两组患者随访屈曲挛缩发生率比较差异无统计学意义(P0.05)。结论关节镜下螺钉与缝线固定治疗ACL胫骨止点撕脱骨折在提高复位稳定性和改善关节活动功能方面效果接近,但关节镜下螺钉固定方案应用可有效缩短手术时间,降低操作难度。

Clinical comparative study of two kinds of fixation methods by arthroscopy in treatment of ACL tibial avulsion fracture

Abstract: Objective To investigate the clinical effects’ differences of screw and suture fixation by arthroscopy in treatment of patients with ACL tibial avulsion fracture. Methods 80 patients with ACL tibial avulsion fracture were chosen and randomly divided into both groups including A group (40 patients) with suture fixation by arthroscopy and B group (40 patients) with screw fixation by arthroscopy; and the operation time, the Lysholm knee score, the IKDC knee function subjective scale score, the difference of uninjured and injured side displacement, and the incidence of flexion contracture of both groups were compared. Results The operation time of B group were significantly shorter than A group (P < 0.05). There was no significant difference in the Lysholm knee score, the IKDC knee function subjective scale score and the difference of uninjured and injured side displacement between the two groups (P > 0.05). There was no significant difference in the incidence of flexion contracture between the two groups (P > 0.05). Conclusion Screw and suture fixation by arthroscopy in treatment of patients with ACL tibial avulsion fracture possess the same clinical effects to higher the stability of reduction and improve the joint motion function; but screw fixation by arthroscopy application can efficiently shorten the operation time and reduce the operation difficulty.