关节镜下骨隧道缝线固定与空心螺钉固定治疗胫骨髁间嵴骨折疗效对比

Efficacy Comparison of Arthroscopic Fixation of Tibial Intercondylar Eminence Fracture using Trans⁃tibial Suture Tape Cerclage and Cannulated Screw

目的对比分析关节镜下骨隧道缝线固定与空心螺钉固定治疗胫骨髁间嵴骨折的临床疗效。方法选取2019年7月至2021年1月商丘市第一人民医院收治的150例胫骨髁间嵴骨折患者作为研究对象,按照随机数表法将其随机分为缝线组(75例)与螺钉组(75例),缝线组患者行关节镜下骨隧道缝线固定,螺钉组患者行关节镜下空心螺钉固定,对比观察两组患者手术时间、膝关节功能评分、膝关节稳定性与骨延迟愈合发生情况结果缝线组患者手术时间与螺钉组无明显差异(t=1.308,P=0.193)。术后6个月,缝线组患者Lysholm评分、国际膝关节文献委员会膝关节评估表(IKDC)评分均明显高于螺钉组(t=4.707、3.560,P<0.001、P=0.001),而轴移试验结果无明显差异(Z=-1.429,P=0.153)。随访过程中,缝线组患者均未出现骨延迟愈合,与螺钉组患者出现2例骨延迟愈合无明显差异(χ^(2)=2.027,P=0.155)。结论与关节镜下空心螺钉固定相比,关节镜下骨隧道缝线固定可明显改善胫骨髁间嵴骨折患者的膝关节功能。

Objective To compare the clinical efficacy of arthroscopic fixation using trans⁃tibial suture tape cerclage and cannulated screw in the treatment of tibial intercondylar eminence fracture.Methods 150 patients with tibial intercondylar eminence fracture admitted to Shangqiu First People’s Hospital from July 2019 to January 2021 were enrolled as research subjects,and divided into suture group(n=75)and screw group(n=75)using the random number table.Arthroscopic fixation using trans⁃tibial suture tape cerclage was performed on patients in the suture group,while arthroscopic fixation with cannulated screw was performed on patients in the screw group.The operation time,knee joint function score,knee joint stability and occurrence of bone delayed healing were compared between the two groups.Results There was no significant difference between the suture group and screw group in terms of operation time(t=1.308,P=0.193).At 6 months after surgery,the Lysholm scores,and the international knee documentation committee knee evaluation form(IKDC)scores of patients in the suture group were both significantly higher compared with the screw group(t=4.707 and 147·3.560,P<0.001,P=0.001),while the results of pivot⁃shift test showed no significantly difference between the two groups(Z=-1.429,P=0.153).During the course of follow⁃up,none of the patients in the suture group had bone delayed healing,and 2 patients suffered bone delayed healing in the screw group,between which there was no significant difference(χ^(2)=2.027,P=0.155).Conclusion Compared with arthroscopic fixation with cannulated screw,arthroscopic fixation using trans⁃tibial suture tape cerclage can significantly improve knee joint functions of patients with tibial intercondylar eminence fracture.