膝关节后方微创小切口外排钉固定治疗后交叉韧带胫骨止点撕脱骨折的临床效果

Clinical effect of minimally invasive small incision on posterior side of knee joint and external screw fixation in the treatment of posterior cruciate ligament tibial avulsion fracture

目的探讨膝关节后方微创小切口外排钉固定治疗后交叉韧带(PCL)胫骨止点撕脱骨折的临床效果。方法回顾性分析2018年1月至2022年6月于本院诊治的46例PCL胫骨止点撕脱骨折患者的临床资料,根据手术方式差异将其分为观察组(微创小切口外排钉固定治疗)与对照组(传统切开复位内固定治疗),每组23例。比较两组的手术效果。结果观察组的手术时间、住院时间明显短于对照组,术中出血量明显少于对照组(P<0.05)。术后1、3、7 d及3个月,观察组的视觉模拟评分法(VAS)评分明显低于对照组(P<0.05)。术后3、8个月,观察组的膝关节Lysholm、国际膝关节文献委员会(IKDC)评分均明显高于对照组(P<0.05)。结论膝关节后方微创小切口外排钉固定治疗PCL胫骨止点撕脱骨折效果显著,手术创伤小,手术时间短,微创入路安全,撕脱骨折块固定牢固,术后患者疼痛明显减轻,住院时间缩短,有利于膝关节功能快速恢复。

Objective To investigate the clinical effect of minimally invasive small incision on posterior side of knee joint and external screw fixation in the treatment of posterior cruciate ligament(PCL)tibial avulsion fracture.Methods The clinical data of 46 patients with PCL tibial avulsion fracture treated in our hospital from January 2018 to June 2022 were retrospectively analyzed.According to the difference of operation methods,the patients were divided into observation group(minimally invasive small incision and external screw fixation)and control group(traditional open reduction and internal fixation),with 23 cases in each group.The surgical effects of the two groups were compared.Results The operation time and hospitalization time of the observation group were significantly shorter than those of the control group,and the intraoperative blood loss was significantly less than that of the control group(P<0.05).At 1,3,7 d and 3 months after operation,the Visual Analogue Scale(VAS)score of the observation group was significantly lower than that of the control group(P<0.05).At 3 and 8 months after operation,the Lysholm and International Knee Documentation Committee(IKDC)scores of the knee joint in the observation group were significantly higher than those in the control group(P<0.05).Conclusion The minimally invasive small incision on posterior side of knee joint and external screw fixation in the treatment of PCL tibial avulsion fracture has a significant effect.It has small surgical trauma,short operation time,safe minimally invasive approach,reliable fixation avulsion fracture block,and can significantly reduce the postoperative pain,shorten the hospitalization time,which is conducive to the rapid recovery of knee joint function.