关节镜下带线锚钉与空心拉力螺钉内固定治疗胫骨髁间嵴撕脱骨折的疗效评价

目的对比分析关节镜下不同内固定方法治疗胫骨髁间嵴撕脱骨折的疗效,为临床治疗提供参考。方法选取钦州市中医医院骨科2014年5月—2015年7月收治的胫骨髁间嵴撕脱骨折患者42例为研究对象,随机抽签法分为锚钉组和螺钉组各21例,锚钉组患者行关节镜下带线锚钉治疗,螺钉组患者行关节镜下空心拉力螺钉内固定治疗,观察两组患者术后切口愈合、膝关节功能变化以及膝关节活动范围。结果两组患者术后切口均I期愈合,无感染情况出现。术后均成功获得随访,随访时间1年以上,术后即刻X线检查示骨折复位良好。术后3个月复查骨折均骨性愈合,无患肢功能障碍。术前两组患者膝关节功能评分差异无统计学意义(P0.05),术后膝关节功能评分均显著提高(P0.05),但锚钉组膝关节功能评分(92.97±3.15)与螺钉组(89.94±3.28)差异无统计学意义(P0.05)。术前两组患者膝关节活动范围差异无统计学意义(P0.05),术后膝关节活动范围显著增加(P0.05),但锚钉组膝关节活动范围(120.6±11.0)与螺钉组(118.5±10.7)差异无统计学意义(P0.05)。结论胫骨髁间嵴撕脱骨折关节镜下带线锚钉和空心拉力螺钉内固定治疗均有很好效果,带线锚钉固定无需二次手术取出,操作简单。

Comparative efficacy of tibial eminence avulsion fracture by using anchor and hollow tension screw fixation under arthroscopy

Objective To analyze the curative effects of fixation in the treatment of tibial eminence avul-sion fracture by using anchor and hollow tension screw under arthroscopy,and provide reference for its clinical treat-ment. Methods Forty two patients with tibial eminence avulsion fracture were selected,who were treated in our hospital from May 2014 to Jul. 2015. Patients were randomly divided into anchor group and screw group. Patients in the anchor group were treated by wire anchor and patients in the screw group were treated by cannulated screw. Inci-sion healing,knee function and motion range of knee joint were observed and compared between the two groups. Re-sults Postoperative incisions were primarily healed without infection. All the patients were followed up for more than 1 year. The X ray examination showed good fracture reduction. Re-examination at 3 months after operation in-dicated that all fractures were healed without limb dysfunction. Before treatment,the knee joint function score and knee joint motion range had no significant difference between the two groups (P>0. 05);after treatment,the knee joint function scores and knee joint motion range in both groups were significantly increased (P<0. 05) ,and there was no significant difference between the two groups ( 92. 97 ± 3. 15 ) vs. ( 89. 94 ± 3. 28 ) , ( 120. 6 ± 11. 0 ) vs. (118. 5 ± 10. 7),P> 0. 05). Conclusion Both anchor and hollow tension screw fixation under arthroscopy can a-chieve good effect in the treatment of tibial eminence avulsion fracture. The wire anchor fixation does not require re-operations,which is more simple.