膝关节镜下复位固定微创治疗胫骨髁间棘撕脱性骨折的临床分析

Analysis of Reduction and Fixation Minimally Invasive Treatment for Avulsion Fracture of Tibial Intercondylar Spine under Knee Arthroscopy

目的探讨膝关节镜下复位固定微创治疗胫骨髁间棘撕脱性骨折的临床疗效。方法选取本院收治的66例外伤后胫骨髁间棘撕脱性骨折患者(2020年12月-2021年12月),随机分为开放组和膝镜下组,每组各33例。膝镜下组行膝关节镜下复位固定微创治疗,开放组常规行开放式内固定手术治疗,对比两组膝关节功能,监测患者康复效果及术后并发症情况。结果膝镜下组术后6个月HSS总分均显著高于开放组(P<0.05)。膝镜下组术后住院时间、骨性愈合时间、部分负重时间和术后完全负重时间均显著低于开放组(P<0.05)。膝镜下组随访6个月术后并发症发生率显著低于开放组(P<0.05)。术后6个月:膝镜下组Lachman试验结果均为阴性,显著高于开放组(P<0.05)。结论膝关节镜下复位固定微创术式,具有负重早、愈合快、康复时间短等优势,可有效提升患者膝关节功能,降低并发症风险,临床应用价值较高,值得推广借鉴。

Objective To investigate clinical effect of arthroscopic reduction and fixation in minimally invasive treatment of avulsion fracture of tibial intercondylar spine.Methods The paper chose 66 patients with avulsion fracture of tibial intercondylar spine after trauma(from December 2020 to December 2021),and divided them into open group and knee arthroscopic group randomly,with 33 cases in each group.Knee arthroscopic group was treated with minimally invasive treatment with arthroscopic reduction and fixation,while open group with routine open internal fixation surgery.Knee joint function between two groups was compared,rehabilitation effect and postoperative complications of patients were monitored.Results Total HSS scores(71.25±7.63)in knee arthroscopic group at 6 months after surgery were significantly higher than open group(55.02±5.24)(P<0.05).Postoperative length of stay(5.23±1.02)days,bone healing time(99.89±17.12)days,partial weight bearing time(32.03±5.26)days,and postoperative complete weight bearing time(40.72±8.14)days in knee arthroscopic grou p was significantly lower than open group,(8.19±2.15,118.01±16.02,45.02±7.02,56.31±7.23)days(P<0.05).Incidence of postoperative complications in knee arthroscopic group after 6 months of follow-up(9.09%,3/33)was significantly lower than open group(30.30%,10/33),(P<0.05).At 6 months after surgery,Lachman test results in knee endoscopy group were all negative(100.00%,33/33),significantly higher than open group(78.79%,26/33),(P<0.05).Conclusion Minimally invasive knee arthroscopic reduction and fixation surgery has advantages of early weight bearing,fast healing,and short recovery time,can improve knee joint function of patients effectively,reduce complications incidence with high clinical application value,which is worthy of promotion and reference.