不同内固定方案治疗Meyers-Mckeever III、IV型胫骨髁间棘骨折临床对比研究

摘要

目的 探讨微创关节镜下医用钢丝与Orthocord缝线内固定方案治疗Meyers- Mckeever Ⅲ、Ⅳ型胫骨髁间棘骨折临床疗效及安全性差异.方法 选取该院2011年6月-2015年6月收治胫骨远端闭合性骨折患者100例.以随机数字表法分为对照组(50例)和观察组(50例),分别采用微创关节镜下医用钢丝与Orthocord缝线内固定方案治疗.比较两组患者手术时间、止血带应用时间、骨性愈合时间、术后HSS评分、Lysholm评分、膝关节屈伸活动度、Lachman试验阳性率及并发症发生率等.结果 观察组患者手术时间与对照组比较,差异有统计学意义(P <0.05),观察组短于对照组;两组患者止血带应用时间和骨性愈合时间比较差异无统计学意义(P >0.05);观察组患者术后HSS评分、Lysholm评分及膝关节屈伸活动度与对照组比较,差异有统计学意义(P <0.05),观察组均优于对照组;两组患者术后Lachman试验阳性率比较差异无统计学意义(P >0.05);两组患者术后并发症发生率比较差异无统计学意义(P >0.05).结论 微创关节镜下Orthocord缝线内固定方案治疗Meyers-Mckeever Ⅲ、Ⅳ型胫骨髁间棘骨折可有效缩短手术用时,提高术后关节功能恢复效果,且未增加并发症发生概率,价值优于医用钢丝.%Objective To investigate the differences in the clinical efficacy and safety of two kinds of minimally invasive arthroscopic internal fixation including medical wire and Orthocord suture in the treatment of tibial eminence fracture of Meyers-Mckeever type III-IV. Methods One hundred patients with tibial eminence fracture of Meyers-Mckeever type III-IV were chosen in our hospital in the period from June 2011 to June 2015 and randomly divided into control group (50 patients) with minimally invasive arthroscopic internal fixation by medical wire and observation group (50 patients) with minimally invasive arthroscopic internal fixation by Orthocord suture. The operation time, tourniquet application time, fracture healing time, HSS score, Lysholm score, and flexion and extension degree of the knee joint after operation, positive rate of Lachman test and complication incidence were compared between the two groups. Results The operation time of the observation group was significantly shorter than that of the control group (P < 0.05). There was no significant difference in the tourniquet application time or fracture healing time between the two groups (P > 0.05). The HSS score, Lysholm score, and the flexion and extension degree of the knee joint after operation in the observation group were significantly better than those in the control group (P < 0.05). There was no significant difference in the positive rate of Lachman test or the complication incidence between the two groups (P > 0.05). Conclusions Compared with minimally invasive arthroscopic internal fixation by medical wire, minimally invasive arthroscopic internal fixation by Orthocord suture can efficiently shorten the operation time, improve the joint function recovery after operation but does not increase the complication incidence in the treatment of tibial eminence fracture of Meyers-Mckeever type III-IV.