CAJ | 학술논문

目的比较关节镜下空心螺钉与缝线固定治疗胫骨髁间棘骨折的临床及功能效果.方法回顾分析因胫骨髁间棘骨折接受关节镜下骨折固定治疗的28例患者资料,根据手术固定方法不同,将患者分为A、B两组,A组采用关节镜下空心螺钉固定;B组采用关节镜下缝线固定.对患者的手术时间、止血带应用时间等围手术期指标进行考察.在末次随访时,采用前抽屉试验、Lachman 试验、特种外科医院评分(Hospital for Special Surgery, HSS)和 Lysholm 评分对膝关节的功能效果进行评估.结果共有23例患者获得最终24个月的临床及影像学随访,A组13例,B组10例.A组和B组的手术时间分为(180.3±12.7)min和(176.2±11.4)min,止血带应用时间分别为(113.7±10.4)min 和(111.6±10.0)min,两组病例在手术时间和止血带应用时间方面,组间差异均无统计学意义(>0.05).所有病例均获骨性愈合,均未出现骨折移位.末次随访时,患侧膝关节前抽屉试验、Lachman试验均为阴性;A、B两组的平均HSS评分分别为95.0±2.9和96.8±2.4,平均Lysholm评分分别为94.2±2.1和93.8±1.9,平均膝关节屈伸活动度分为别为137.1°±9.0°和135.6°±12.1°,组间差异均无统计学意义(>0.05).结论胫骨髁间棘骨折采用关节镜下空心螺钉或缝合线固定均可确定满意的临床疗效,患者术后2年的功能效果良好.
목적비교관절경하공심라정여봉선고정치료경골과간극골절적림상급공능효과.방법회고분석인경골과간극골절접수관절경하골절고정치료적28례환자자료,근거수술고정방법불동,장환자분위A、B량조,A조채용관절경하공심라정고정;B조채용관절경하봉선고정.대환자적수술시간、지혈대응용시간등위수술기지표진행고찰.재말차수방시,채용전추체시험、Lachman 시험、특충외과의원평분(Hospital for Special Surgery, HSS)화 Lysholm 평분대슬관절적공능효과진행평고.결과공유23례환자획득최종24개월적림상급영상학수방,A조13례,B조10례.A조화B조적수술시간분위(180.3±12.7)min화(176.2±11.4)min,지혈대응용시간분별위(113.7±10.4)min 화(111.6±10.0)min,량조병례재수술시간화지혈대응용시간방면,조간차이균무통계학의의(>0.05).소유병례균획골성유합,균미출현골절이위.말차수방시,환측슬관절전추체시험、Lachman시험균위음성;A、B량조적평균HSS평분분별위95.0±2.9화96.8±2.4,평균Lysholm평분분별위94.2±2.1화93.8±1.9,평균슬관절굴신활동도분위별위137.1°±9.0°화135.6°±12.1°,조간차이균무통계학의의(>0.05).결론경골과간극골절채용관절경하공심라정혹봉합선고정균가학정만의적림상료효,환자술후2년적공능효과량호.
Objective To explore The comparison between arthroscopic cannulated screw and suture fixation on tibial spine fractures curative effect and functional effects. Methods Retrospective analysis of 28 patients' information accepted arthroscopic fixation of the fracture due to tibial spine fractures, depending on the surgical fixation methods, The patients were divided into two groups of A, B. Patients were received arthroscopic cannulated screw fixation in A group and ar-throscopic suture fixation in B group. Conduct the investigations of the perioperative indicators of the patients' surgical time, tourniquet application. At the last follow-up, assessed the knee function effects with the anterior drawer test, Lachman test, the Hospital for Special Surgery score (Hospital for Special Surgery, HSS) and the Lysholm score. Results 23 patients with clinical and radiologic follow-up for 24 months, 13 patients in group A and 10 cases in group B. Group A and group B Operation time were (180.3 ± 12.7) min and (176.2 ± 11.4) min, Tourniquet application times are (113.7 ± 10.4) min and (111.6 ± 10.0) min respectively. The difference between the groups was not statistically significant ( >0.05). All patients were bone union and not displaced fractures. At the last follow-up, the ipsilateral knee anterior drawer test and Lachman test were negative; average HSS score of A, B two groups were 95.0 ± 2.9 and 96.8 ± 2.4, mean Lysholm score were 94.2 ± 2.1 and 93.8 ± 1.9, average knee range of motion were 137.1°± 9.0° and 135.6°± 12.1°, the difference between the groups was not statistically significant ( >0.05). Conclusion Both tibial spine fracture with arthroscopic cannulated screw and suture fixation can determine a satisfactory clinical efficacy, and 2 years after surgery in patients with good functional outcomes.