摘要
目的探究小切口切开复位内固定与关节镜下高强度不可吸收缝线治疗前交叉韧带(ACL)胫骨新鲜止点撕脱骨折的疗效。方法回顾性分析2018年4月—2020年4月汕头市中心医院收治的72例ACL胫骨新鲜止点撕脱骨折患者的临床病例资料,采用随机数字表法分为对照组和实验组,每组36例,对照组采用小切口切开复位内固定治疗,实验组采用关节镜下高强度不可吸收缝线治疗。比较两组患者的一般资料、手术指标及术后不良反应发生情况;比较两组患者治疗前后的各项膝关节功能指标,并采用随机行走模型进行评价。计数资料采用百分比表示,组间对比采用χ2检验;计量资料采用均数±标准差(Mean±SD)表示,组间对比独立t检验,组内对比采用配对t检验。结果两组患者的一般资料、术中出血量、术前Lysholm评分、IKDC评分、Tegner评分、膝关节活动度、双侧胫骨后移距离差值差异无统计学意义(P>0.05)。实验组手术时间、住院时间、术后首次下地活动时间、骨愈合时间、不良反应总发生率分别为(68.41±7.65)min、(11.93±3.24)d、(6.37±1.85)d、(23.65±2.28)周、2.78%(1/36),对照组分别为(55.37±8.62)min、(13.45±2.96)d、(8.16±2.08)d、(25.79±2.46)周、22.22%(8/36),两组相比差异具有统计学意义(P<0.05)。实验组治疗后的Lysholm评分、IKDC评分、Tegner评分、膝关节活动度、双侧胫骨后移距离差值分别为(85.27±5.28)分、(85.43±1.74)分、(6.65±1.41)分、(108.45±5.79)°、(1.12±0.65)mm,对照组分别为(79.73±4.69)分、(80.37±1.59)分、(5.72±1.31)分、(97.58±5.42)°、(2.24±0.72)mm,两组相比差异具有统计学意义(P<0.05)。随机行走模型评价实验组的膝关节功能改善情况明显优于对照组。结论关节镜下高强度不可吸收缝线治疗ACL胫骨止点撕脱骨折能够明显改善患者的膝关节功能指标,术后恢复快,安全性较高,具有广阔的临床应用前景。
Objective To explore the efficacy of small incision open reduction and internal fixation and arthroscopic high strength non-absorbable suture in the treatment of tibial avulsion fracture of anterior cruciate ligament(ACL).Methods The clinical data of 72 patients with ACL tibial avulsion fracture treated in Shantou Central Hospital from April 2018 to April 2020 were analyzed retrospectively.The patients were randomly divided into control group(n=36)and experimental group(n=36).The control group was treated with small incision open reduction and internal fixation and the experimental group was treated with high intensity non-absorbable suture under arthroscopy.The general data,surgical indexes and postoperative adverse reactions of the two groups were compared,and the knee joint function indexes of the two groups before and after treatment were compared and evaluated by random walking model.The counting data were expressed by percentage,the comparison between groups was expressed by chi-square test,the measurement data was expressed by mean±standard deviation,the independent t-test was used for inter-group comparison,and the paired t-test was used for intra-group comparison.Results There was no significant difference in general information,intraoperative blood loss,preoperative Lysholm score,IKDC score,Tegner score,knee mobility,and bilateral tibial displacement distance between the two groups of patients(P>0.05).In the experimental group,the operation time,hospitalization time,the first postoperative time to move to the ground,bone healing time,and the total incidence of adverse reactions were(68.41±7.65)min,(11.93±3.24)d,(6.37±1.85)d,(23.65±2.28)weeks,2.78%(1/36),the control group were(55.37±8.62)min,(13.45±2.96)d,(8.16±2.08)d,(25.79±2.46)weeks,22.22%(8/36),the difference between the two groups was statistically significant(P<0.05).The Lysholm score,IKDC score,Tegner score,range of motion of the knee joint,and the difference of bilateral tibial displacement distance after treatment in the experimental gr
作者
黄晋
陈树鑫
林晓旭
翁科捷
张育锋
邱雪立
Huang Jin;Chen Shuxin;Lin Xiaoxu;Weng Kejie;Zhang Yufeng;Qiu Xueli(Department of Orthopedics,Shantou Central Hospital,Shantou 515000,China)
出处
《国际外科学杂志》
2021年第7期460-466,共7页
International Journal of Surgery
基金
汕头市第一批医疗卫生自筹经费类科技计划项目(汕府科[2017]119号-10)。
关键词
关节镜
前交叉韧带
缝线
胫骨骨折
疗效比较研究
Arthroscopes
Anterior Cruciate Ligament
Sutures
Tibial fractures
Comparative effectiveness research
