关节镜下空心螺钉治疗前交叉韧带胫骨止点撕脱骨折疗效观察

摘要

目的 探讨关节镜下空心螺钉治疗前交叉韧带胫骨止点撕脱骨折患者的临床效果.方法 回顾性分析我院2010年1月~2015年12月收治的32例经关节镜下治疗的前交叉韧带胫骨止点撕脱骨折患者的临床资料,骨折分型均为Ⅱ、Ⅲ型,根据内固定方式将患者分为A组(16例)和B组(16例),分别采用空心螺钉和钢丝内固定.术后随访6~12个月,采用Lysholm评分、IKDC评分及Tegner评分评价两组患者治疗前后膝关节功能,采用Lachman试验和Pivot-shift试验评价膝关节稳定性.结果 与B组比较,A组手术时间短,术中出血少,术后住院时间短,差异均有统计学意义(P<0.05).两组患者治疗前Lysholm评分、IKDC评分和Tegner评分均无统计学差异(P>0.05),治疗后三种评分均较术前显著改善(P<0.05),但组间比较差异无统计意义(P>0.05);两组患者治疗前Lachman试验和Pivot-shift试验阳性率均无统计学差异(P>0.05),治疗后则均较术前显著降低(P<0.05),但组间比较差异无统计意义(P>0.05).结论 关节镜下空心螺钉治疗前交叉韧带胫骨止点撕脱骨折手术操作时间短,操作简单,可有效改善患者膝关节功能和稳定性.%Objective To investigate the clinical effect of arthroscopic cannulated screws internal fixation for the treatment of tibial avulsion fracture of anterior cruciate ligament. Methods The clinical data of 32 patients with tibial avulsion fracture of anterior cruciate ligament treated by arthroscopy in our hospital from January 2010 to December 2015 were retrospectively analyzed.According to the different internal fixation materials, all 32 cases were divided into group A and group B with 16 cases for each, and were carried out internal fixation with hollow screw and steel wire respectively.All cases were followed up for 6 to 12 months.The knee joint function were evaluated by Ly-sholm score, IKDC score and Tegner score, and the knee joint stability was assessed by Lachman test and Pivot-shift test in both two groups before and after treatment. Results Compare to group B, the operation time was shorter, the intra-operative blood loss volume was less and the post-operative hospital stays was shorter in group A, and there was statistical difference between two groups (P <0.05).The Lysholm score, IKDC score and Tegner score was im-proved after the surgery than those before the surgery in both groups (P <0.05), but there was no statistical differ-ence between the two groups after the surgery (P >0.05).The positive rate of Lachman test and Pivot-shift test was decreased after the surgery than those before the surgery in both two groups (P <0.05), but no statistically signifi-cant difference was found between the two groups after the surgery (P >0.05). Conclusion The internal fix-ation of arthroscopic cannulated screws can shorten the operative duration and remarkable improved the function and stability of knee joint for the patients with tibial avulsion fracture of anterior cruciate ligament insertion .