关节镜下空心螺钉与缝线内固定治疗胫骨髁间棘骨折

Treatment of Tibial Intercondylar Spine Fracture with Cannulated Screw and Suture Under Arthroscopy

目的观察分析在关节镜下采用空心螺钉和缝线内固定的疗法来治疗胫骨髁间棘骨折的效果差异,以分析这两种方法对治疗效果的优缺点。方法从江苏省无锡市惠山区第二人民医院2018年6月-2020年8月接收的胫骨髁间棘骨折患者中随机抽取106例患者作为研究对象,随机分为对照组和观察组,每组各53例,对两组患者进行不同的手术方法,其中对照组的手术治疗方法为关节镜下缝线内固定治疗,观察组的手术治疗方法为关节镜下空心螺钉治疗,对比观察两组的治疗效果。结果就患者膝关节功能评分而言,观察组患者的优良率和对照组数据差异不明显,相比不具有统计学意义(P>0.05);观察组的手术时间、功能训练时间以及住院时长均短于对照组,差异明显且均具有统计学意义(P<0.05);观察组治疗后的BGP、TGF-β1、IGF-1水平均比对照组高(P<0.05)。结论就胫骨髁间棘骨折患者而言,关节镜下空心螺钉和缝线内固定治疗的方式起到的治疗效果差异不大,表现在对于患者膝盖关节的功能评估分数接近,然而空心螺钉内固定的使用,改善患者的骨钙素、转化生长因子-β1、胰岛素样生长因子-1水平,加快膝关节功能的恢复,明显提高临床疗效,因此空心螺钉内固定优势较缝线内固定更明显,具有积极的临床意义,值得进一步推广。

Objective To observe and analyze effect difference of hollow screw and suture internal fixation in treatment of tibial intercondylar spine fracture under arthroscopy,and analyze advantages and disadvantages of two methods.Methods The paper chose 106 patients with tibial intercondylar spine fracture received in our hospital from June 2018 to August 2020 as research objects,and divided them into control group and observation group randomly,with 53 cases in each group.Different surgical methods were carried on for two groups,control group was treated with suture internal fixation under arthroscopy,observation group was hollow screw under arthroscopy.Curative effect of two groups was compared and observed.Results Knee function scores showed no significant difference between excellent and good rate of observation group and control group,operation time,functional training time and length of stay of observation group was shorter than control group,difference was statistically significant,(P<0.05).Levels of BGP,IGF-β1,IGF-1 were higher than control group(P<0.05).Conclusion There is little difference in curative effect of arthroscopic hollow screw and suture internal fixation for patients with tibial intercondylar spine fracture,with close functional evaluation scores of knee joint.However,hollow screw internal fixation can improve levels of osteocalcin and transforming growth factor-β1,Insulin like growth factor-1,accelerate recovery of knee function and improve clinical curative effect significantly.Therefore,hollow screw internal fixation can achieve more obvious advantages than suture internal fixation,which has positive clinical significance and is worthy of further promotion.