关节镜下双排锚钉缝合桥技术治疗单纯肱骨大结节撕脱骨折的疗效分析

Clinical effect of arthroscopic double-row anchored suture bridge technique in the treatment of simple humeral greater tubercle avulsion fractures

目的探讨关节镜下双排锚钉缝合桥技术治疗单纯肱骨大结节撕脱骨折的疗效。方法2015年1月~2018年12月间本院骨科收治的单纯肱骨大结节撕脱骨折病人68例,按治疗方式分为两组,关节镜组38例,行关节镜下双排锚钉缝合桥技术治疗,钢板组30例,行锁定钢板内固定治疗。比较两组病人围手术期相关指标,记录病人手术前和手术后(末次随访)的美国肩肘外科医师(ASES)评分、视觉模拟评分(VAS)、美国加州洛杉矶大学(UCLA)功能评分,统计病人术后关节活动度、术后并发症发生情况及治疗满意度。结果关节镜组手术时间长于钢板组(P<0.05),术中出血量少于钢板组(P<0.05),住院时间短于钢板组(P<0.05),两组骨折愈合时间比较,差异无统计学意义(P>0.05),两组术后的ASES评分和UCLA评分均较术前显著提高,VAS评分显著降低,但两组术后ASES评分和UCLA评分组间比较,差异无统计学意义(P>0.05)。关节镜组术后VAS评分低于钢板组,术后肩关节活动度(90°内旋、外展上举和前屈上举)高于钢板组,差异有统计学意义(P<0.05),关节镜组与钢板组术后并发症发生率(5.26%vs 23.33%)、治疗满意度((97.37%vs 80.00%)比较差异有统计学意义(P<0.05)。结论关节镜下双排锚钉缝合桥技术治疗单纯肱骨大结节撕脱骨折效果满意,可显著改善病人术后关节功能,术后疼痛程度轻,术后并发症少,病人满意度高。

Objective To explore the clinical effect of arthroscopic double-row anchored suture bridge technique in treating simple humeral greater tuberosity avulsion fractures. Methods From January2015 to December 2018,68 patients with avulsion fracture of greater tuberosity of humerus were treated in the Department of Orthopedics of our hospital,they were divided into two groups according to the treatment methods. 38 patients who underwent arthroscopic double-row anchor suture bridge technique were included in the arthroscopy group,thirty patients who underwent locking plate internal fixation were included in the plate group. Compare the perioperative indicators of the two groups of patients,record the American shoulder and elbow surgeon( ASES) score,visual analog scale( VAS),and the University of California Los Angeles( UCLA) functional score before and after the operation( last follow-up),and count the patients Postoperative joint range of motion,postoperative complications and patient satisfaction with treatment.Results The operation time in the arthroscopic group was significantly longer than that in the steel plate group( P < 0. 05),the intraoperative blood loss was significantly less than that in the steel plate group( P < 0. 05),and the hospitalization time was significantly shorter than that in the steel plate group( P <0. 05);there was no significant difference in fracture healing time between the two groups( P > 0. 05);the ASES score and UCLA score of the two groups were higher than those before operation,but the postoperative ASES score and UCLA evaluation between the two groups showed no statistically significant difference( P > 0. 05);while the VAS score was significantly lower in the arthroscopic group than in the plate group( P < 0. 05);The range of motion of shoulder joint( 90 ° internal rotation,abduction and forward flexion) in arthroscopy group was significantly higher than that in steel plate group( P < 0. 05);There were significant differences in the incidence of postoperative complications( 5. 26% vs 23. 33%)and patient satisfaction( 97. 37% vs 80. 00%) between the arthroscopic group and the plate group( P <0. 05). Conclusion Arthroscopic double row anchor nail suture bridge technique for the treatment of simple humeral greater tuberosity avulsion fracture has satisfactory effect,can significantly improve the postoperative joint function of patients,postoperative pain degree is light,postoperative complications are less,and patient satisfaction is high.