关节镜下两种不同固定方式治疗髁间嵴撕脱骨折的疗效比较
Comparative Analysis of Two Different Fixation Methods for Treatment of the Intercondylar Eminence Fractures of Tibia
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摘要: [摘要]目的 探讨关节镜下应用空心拉力螺钉、双带线锚钉固定髁间嵴撕脱骨折的疗效.方法 回顾性分析2006年1月至2012年1月收治的68例髁间嵴撕脱骨折患者,其中33例采用空心拉力螺钉固定, 35例采用双带线锚钉固定.术前进行X线拍片,术后随访3个月、6个月、12个月、36个月分别对患者进行X线拍片和Lysholm关节功能评分.结果 经平均时间37个月(24~38个月)随访.门诊复查X线片显示两组骨折愈合平均时间为术后5~11周,平均7周,骨折均获得良好骨性愈合.对于Ⅱ型、Ⅲ型骨折2组的Lysholm评分在3个月和6个月期间差异无统计学意义(P>0.05),而在术后12个月和36个月期间,2组组间差异有统计学意义(P<0.05)但对于Ⅳ型骨折2组术后均有膝前疼痛和活动受限,2组的Lysholm评分在3月、6月、12月、36月差异无统计学意义( P>0.05).结论 关节镜下治疗胫骨髁间棘骨折的过程中,应综合考虑患者的临床情况与个人要求制定个性化的内固定方案.Abstract: [Abstract]Objective To compare the effect of hollow screw and double suture anchors for the treatment of the intercondylar eminence fractures of tibia. Methods The data of 68 patients with intercondylar eminence fractures of tibia from January 2006 to January 2012 were retrospectively reviewed. 33 patients of them received treatment of hollow screw,35 patients received double suture anchors. All patients had X-ray films before operation. After follow-up of 3,6,12 and 36 months, they all were examined by X-ray eminence in an appropriate position. Union time was from 6 to 12 weeks and evaluated by Lysholm system. Results After a follow-up for 24 to 43 months and the average period was 36 months. A total of 68 patients turned up. The outcome of treatment was evaluated on the basis of X-ray and clinical findings in hollow screw group and double suture anchors group. Union and average time was 8 weeks. During the follow-up time, clinical evaluation included the range of motion and knee joint stability was examined and no knee joint instability and abnormal activity were found. During the 3 months and 6 months, there were significant differences between hollow screw group and double suture anchors group(P > 0.05). But during the follow-up from 12 to 24 months, there were significant differences between hollow screw group and double suture anchors group(P>0.05)according to Lysholm system,clinical evaluation including range of motion and knee pain was examined and knee pain and abnormal activity were found in this two groups. Conclusion Clinical characteristics of patients and individual requirement should be considered comprehensively before an individual treatment choice is made for the treatment of the intercondylar eminence fractures of tibia.
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