关节镜下不同固定方式治疗胫骨髁间棘骨折的效果比较

Comparison on the Effects of Different Fixation Methods Under Arthroscopy in the Treatment of Tibial Intercondylar Eminence Fracture

目的比较关节镜下不同固定方式治疗胫骨髁间棘骨折的临床效果。方法50例胫骨髁间棘骨折患者随机分为两组各25例,A组采用关节镜下爱惜邦缝线固定术治疗,B组采用关节镜下空心钉固定术治疗。比较两组的手术时间、术后功能训练开始时间、骨折愈合时间,以及术后膝关节功能相关指标。结果两组的手术时间、术后功能训练开始时间以及骨折愈合时间比较,差异无统计学意义(P>0.05)。术后3、6、9个月,两组的膝关节活动度、Lysholm评分以及Lachman试验+抽屉试验阳性比例比较,差异无统计学意义(P>0.05)。结论对于胫骨髁间棘骨折患者,关节镜下爱惜邦缝线固定术与空心钉固定术均可获得满意的治疗效果,但爱惜邦缝线固定对于骨折块较小、较碎及儿童骨骺未闭合病例具有一定优势,且术后免于内固定物取出。

Objective To compare the clinical effects of different fixation methods under arthroscopy in the treatment of tibial intercondylar eminence fracture.Methods 50 patients with tibial intercondylar eminence fracture were randomly and equally divided into two groups.Group A was treated with Ethibond suture fixation under arthroscopy,and group B was treated with cannulated screw fixation under arthroscopy.The operation time,the starting time of postoperative functional training,the fracture healing time,and the relevant indicators of postoperative knee joint function were compared between two groups.Results No statistical difference was found between two groups in the operation time,starting time of postoperative functional training and fracture healing time(P>0.05).3,6 and 9 months after surgery,the range of motion of keen joint,Lysholm score and positive proportion of Lachman test+drawer test was found between two groups(P>0.05).Conclusions For patients with tibial intercondylar eminence fracture,both Ethibond suture fixation and cannulated screw fixation under arthroscopy can achieve good treatment effect.However,Ethibond suture fixation has certain advantages for the cases with small and broken fracture pieces and cases of children with unclosed epiphyseal,and it is not necessary to remove the internal fixator after surgery.