两种治疗方案对前十字韧带胫骨止点撕脱骨折患者术后膝关节功能及稳定性的影响研究

Effect of Two Treatment Regimens on Postoperative Knee Function and Stability in Patients with Tibial Avulsion Fractures of Anterior Cruciate Ligament

目的观察两种治疗方案对前十字韧带(ACL)胫骨止点撕脱骨折患者术后膝关节功能及稳定性的影响。方法回顾性分析2020年1月至2022年1月在四川省骨科医院就诊的ACL胫骨止点撕脱骨折患者临床资料,从接受关节镜下“8”字缝线治疗的患者中随机抽取71例纳入对照组,从接受关节镜下缝线桥固定治疗的患者中随机抽取71例纳入试验组,术后患者均已随访12个月。比较两组患者的临床治疗情况和术后并发症发生情况,记录其术后3个月时(T1)、术后6个月时(T2)和术后12个月时(T3)的膝关节功能[国际膝关节文献委员会膝关节评估表(IKDC)]、稳定性(KT-2000值)和膝关节活动度。结果试验组患者的手术时间高于对照组,而住院时间和骨折愈合时间低于对照组(P<0.05);两组术后并发症发生率差异无统计学意义(P>0.05);T1、T2和T3时,试验组患者的IKDC评分和膝关节活动度高于对照组(P<0.05);试验组患肢的KT-2000值低于对照组(P<0.05),且T3时试验组患者患肢和健肢的KT-2000值差异无统计学意义(P>0.05),对照组患肢的KT-2000值高于健肢(P<0.05)。结论采用关节镜下缝线桥固定治疗ACL胫骨止点撕脱骨折患者具有明显疗效,能够有效改善患者膝关节功能,提高膝关节稳定性和活动度,减少术后并发症发生情况。

Objective To explore the effect of two treatment regimens on postoperative knee function and stability in patients with tibial avulsion fractures of anterior cruciate ligament(ACL).Methods The clinical data of patients with tibial avulsion fractures of ACL in Sichuan Province Orthopedic Hospital from January 2020 to January 2022 were retrospectively analyzed.Seventy-one patients who received arthroscopic"8"-shaped suture treatment were randomly selected as the control group,and 71 patients who received arthroscopic suture bridge fixation treatment were randomly selected as the experimental group.The patients were followed up for 12 months after surgery.The clinical treatment status and incidence of postoperative complications were compared between the two groups.The knee function[International Knee Documentation Committee(IKDC)],stability(KT-2000 value)and knee range of motion at 3 months(T1),6 months(T2)and 12 months(T3)after surgery were recorded.Results The duration of surgery in the experimental group was longer than that in the control group,while the hospital stay and fracture healing time in the experimental group were shorter than those in the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).At T1,T2 and T3,the IKDC score and knee range of motion in the experimental group were higher than those in the control group(P<0.05).The KT-2000 value of the affected limb in the experimental group was lower than that in the control group(P<0.05).There was no significant difference in the KT-2000 value between the affected limb and the healthy limb in the experimental group at T3(P>0.05).And the KT-2000 value of the affected limb was higher than that of the healthy limb in the control group at T3(P<0.05).Conclusion Arthroscopic suture bridge fixation is effective in the treatment of patients with tibial avulsion fractures of ACL,which effectively improves the knee function,stability and range of motion,and reduces postoperative complications.