空心螺钉技术与可吸收性锚钉Double-Pulley技术治疗后交叉韧带胫骨止点撕脱骨折的临床疗效比较

Comparison of clinical efficacy between cannulated screw technique and absorbable anchor Double-Pulley technique in the treatment of tibial avulsion fracture of posterior cruciate ligament

目的比较空心螺钉技术与可吸收性锚钉Double-Pulley技术治疗后交叉韧带(PCL)胫骨止点撕脱骨折的临床疗效。方法选取2013年1月至2019年7月本院收治的120例PCL胫骨止点撕脱骨折患者作为研究对象,根据手术方法不同分为空心螺钉技术组与Double-Pulley技术组,每组60例。空心螺钉技术组采用空心螺钉固定治疗,Double-Pulley技术组采用可吸收锚钉Double-Pulley固定治疗,比较两组手术时间、切口长度、术中出血量、内固定失效率、术后并发症发生率、住院时间、患者满意度、屈曲活动度、Lysholm评分及视觉模拟评分法(VAS)评分。结果两组术中出血量比较差异无统计学意义;Double-Pulley技术组手术时间、切口长度均短于空心螺钉技术组,差异有统计学意义(P<0.05)。两组内固定失效率、术后并发症发生率比较差异无统计学意义;Double-Pulley技术组住院时间短于空心螺钉技术组,患者满意度高于空心螺钉技术组,差异有统计学意义(P<0.05)。Double-Pulley技术组屈曲活动度大于空心螺钉技术组,Lysholm评分高于空心螺钉技术组,VAS评分低于空心螺钉技术组,差异有统计学意义(P<0.05)。结论使用可吸收锚钉Double-Pulley技术固定PCL胫骨止点撕脱骨折,更有利于患者恢复膝关节功能,减少并发症,缩短住院时间,不需二次手术取出内固定物,提高患者的满意度,值得临床推广应用。

Objective To compare the clinical efficacy of cannulated screw technique and absorbable anchor Double-Pulley technique in the treatment of tibial avulsion fracture of posterior cruciate ligament(PCL).Methods A total of 120 patients with tibial avulsion fracture of PCL admitted to our hospital from January 2013 to July 2019 were selected as the research subjects,and they were divided into the hollow screw technology group and the Double-Pulley technique group according to different surgical methods,with 60 cases in each group.The operation time,incision length,bleeding volume,failure rate of internal fixation,incidence of postoperative complications,hospitalization time,patient satisfaction,flexion activity,Lysholm score and visual analogue scale(VAS)score were compared between the two groups.Results There was no significant difference in intraoperative blood loss between the two groups;the operation time and incision length in the Double-Pulley technique group were shorter than those in the hollow screw technology group,and the differences were statistically significant(P<0.05).There were no significant difference in the failure rate of internal fixation and the incidence of postoperative complications between the two groups.The hospitalization time in the Double-Pulley technique group was shorter than that in the hollow screw technique group,and the patient satisfaction was higher than that in the hollow screw technique group,the differences were statistically significant(P<0.05).The flexion activity of Double-Pulley technique group was greater than that in the hollow screw technology group,the Lysholm score was higher than that in the hollow screw technology group,and the VAS score was lower than that in hollow screw technology group,the differences were statistically significant(P<0.05).Conclusion The use of absorbable anchor Double-Pulley technique to fix PCL tibial avulsion fracture is more conducive to the recovery of knee joint function,reduce complications,shorten hospitalization time,and improve patient satisfaction without secondary surgery,and is worthy of clinical promotion and application.