摘要
背景:前交叉韧带胫骨止点撕脱性骨折需尽早行手术复位内固定,目前临床治疗方案中常用切开复位(可吸收螺钉、空心钉、钢丝、钛缆等)内固定,创伤较大,术后并发症多。而关节镜下行前交叉韧带下止点骨折复位弹性(缝线)内固定具有微创、术野清晰、固定准确性高、并发症少、骨折复位愈合好、符合生物力学要求、关节功能康复快等优点,但也有强度不够、骨块切割等缺点。目的:比较关节镜下Fiber Tape环形固定与开放内固定治疗前交叉韧带下止点撕脱骨折的疗效。方法:收集2017年1月至2018年12月上海中冶医院骨科收治的32例前交叉韧带下止点撕脱骨折患者,所有患者对治疗方案均知情同意,且得到医院伦理委员会批准。根据手术方法分成2组,微创组17例采用关节镜下Fiber Tape环形固定治疗;开放组15例采用开放手术骨折复位(空心拉力螺钉、钛缆、钢丝等)内固定治疗。记录所有患者手术时间、出血量、术后并发症情况;于术前及术后第1,6个月记录膝关节活动范围、Lysholm评分及国际膝关节评分委员会评分,摄X射线片评价骨折复位愈合情况。结果与结论:①所有患者获得随访,时间6-13个月;②2组患者年龄组成、骨折类型、受伤原因、术前评分差异无显著性意义;③术后X射线片复查骨折均得到满意复位,术后未出现神经、血管损伤、骨折移位情况,术后6个月骨折均愈合良好;④2组手术时间、术后并发症发生率差异无显著性意义,2组术中出血量差异有显著性意义(P=0.036);⑤膝关节活动度:2组患者术后1个月膝关节活动度显著大于术前(P<0.05),术后6个月膝关节活动度显著大于术后1个月(P<0.05);术后1,6个月微创组膝关节活动度显著大于开放组(P<0.05);⑥Lysholm膝关节功能评分及国际膝关节评分委员会评分:2组患者术后1个月Lysholm膝关节功能评分及国际膝关节评分委员会评�
BACKGROUND:The avulsion fracture of tibial insertion of anterior cruciate ligament needs to be operated and fixed as early as possible.At present,the open reduction(absorbable screw,hollow screw,steel wire,and titanium cable)is commonly used in the clinical treatment plan for internal fixation,which is more traumatic and has many postoperative complications.Arthroscopic reduction and elastic(suture)internal fixation of anterior cruciate ligament fracture has the advantages of minimally invasive,clear surgical field,high fixation accuracy,few complications,good fracture reduction and healing,meeting the biomechanical requirements,and allowing rapid recovery of joint function,but also has the disadvantages of insufficient strength,and osteotomy.OBJECTIVE:To compare the treatment efficacy of arthroscopic technique with Fiber Tape circular fixation and open reduction and fixation for the avulsion fracture of tibial insertion of anterior cruciate ligament.METHODS:Thirty-two patients with tibial eminence fracture at Department of Orthopedics of Shanghai China Metallurgical Hospital from January 2017 to December 2018 were enrolled.All patients signed the informed consents and the study was approved by the Ethics Committee.The patients were divided into two groups based on surgical methods:minimally invasive group(n=17,arthroscopic reduction and Fiber Tape circular fixation)and open group(n=15,open reduction and hollow tension screw fixation).The operation time,blood loss,and postoperative complications were recorded.The range of motion of knee joint,Lysholm score,and International Knee Documenting Committee score before operation,1 and 6 months after surgery were recorded.X-ray film was used to evaluate fracture healing.RESULTS AND CONCLUSION:(1)All patients were followed up for 6-13 months.(2)There were no significant differences in age composition,fracture type,cause of injury or preoperative score between two groups.(3)X-ray film showed satisfactory fracture reduction after operation.There were no neurological,vascul
作者
李广峰
王思成
彭勇
杨国庆
吴献民
刘祥飞
曹中华
尹志峰
张鑫
张友忠
Li Guangfeng;Wang Sicheng;Peng Yong;Yang Guoqing;Wu Xianmin;Liu Xiangfei;Cao Zhonghua;Yin Zhifeng;Zhang Xin;Zhang Youzhong(Department of Orthopedics,Shanghai China Metallurgical Hospital,Shanghai 200941,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第10期1591-1596,共6页
Chinese Journal of Tissue Engineering Research
基金
上海市卫生和计划生育委员会科研课题(2016401456)，项目负责人：王思成
上海中冶医院院内课题(17-ZYYA-4)，项目负责人：王思成、李广峰~~
关键词
前交叉韧带撕脱骨折
关节镜
Fiber
Tape
空心拉力螺钉
内固定
avulsion fracture of tibial insertion of anterior cruciate ligament
arthroscopic technique
Fiber Tape
hollow screw
internal fixation
