摘要
目的 比较缝线桥技术和空心螺钉加压方法治疗青少年胫骨结节撕脱性骨折的疗效。方法 采取回顾性研究,收集了2015年10月至2022年10月枣阳市第一人民医院骨科收治并完整随访的37例青少年胫骨结节撕脱性骨折患者。其中,男36例,女1例;年龄13~17岁,平均15.2岁。根据撕脱骨块的固定方式分为缝线桥组(可吸收带线锚钉双排缝线桥固定,19例)和空心螺钉组(普通空心金属螺钉加压固定,18例)。比较两组患者术后1、2、3个月和末次随访时(>12个月)的膝关节屈曲角度、Bostman功能评分,以及术后3、6个月和末次随访时(>12个月)的Tegner活动评分;记录术后3个月及末次随访膝关节功能满意度(Bostman评分分级);同时记录术后并发症情况。结果 所有患者随访12~24个月,中位随访时间18个月。术后缝线桥组术后1、2个月的膝关节屈曲角度、Bostman功能评分缝线桥组均优于空心螺钉组,差异均有统计学意义(P<0.05),术后3个月及末次随访两组膝关节屈曲角度、Bostman功能评分比较,差异无统计学意义(P>0.05)。术后3个月Tegner活动评分缝线桥组优于空心螺钉组,差异有统计学意义(P<0.05);术后6个月及末次随访Tegner活动评分两组比较差异无统计学意义(P>0.05)。术后3个月患者满意度情况(Bostman功能评分分级)缝线桥组优于空心螺钉组,差异有统计学意义(P<0.05);但末次随访患者满意度情况(Bostman功能评分分级)两组比较差异无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 相比空心螺钉或结合钢丝张力带固定技术,缝线桥技术固定能达到螺钉固定强度,允许早期开展膝关节屈伸功能锻炼,术后异物激惹少,并发症发生率低,骨折愈合后也无需二次取出内固定。
Objective To compare the efficacy of suture bridge technique and hollow screw compression in the treatment of avulsion fracture of tibial tubercle in adolescents.Methods A retrospective study was conducted to collect 37 cases of avulsion fracture of tibial tubercle in adolescents from October 2015 to October 2022 in the department of orthopedics of Zaoyang First People's Hospital.Among them,there were 36 males and 1 female;the age ranged from 13 to 17 years,with an average age of 15.2 years.According to the fixation method of the avulsion bone block,they were divided into two groups:Suture bridge group(absorbable double-row suture bridge fixation with belt anchor,19 cases)and hollow screw group(ordinary hollow metal screw compression fixation,18 cases).The knee flexion angle,Bostman function score at 1,2,3 months after operation and the last follow-up(>12 months),Tegner activity score at 3 and 6 months after operation and at the last follow-up(>12 months),the satisfaction of patients(Bostman function score classification)at 3 months after operation and at the last follow-up,and postoperative complications were compared between the two groups.Results The median follow-up time was 18 months(12 to 24 months).The knee flexion angle and Bostman function score of the suture bridge group were better than those of the hollow screw group at 1 month and 2 months after surgery,with statistical significance(P<0.05).The knee flexion angle and Bostman function score of the two groups were not statistically significant at 3 months after surgery and at the last follow-up(P>0.05).Tegner activity score at 3 months after surgery the suture bridge group was better than the hollow screw group,the difference was statistically significant(P<0.05),and there was no statistically significant difference in Tegner activity score 6 months after surgery and at the last follow-up(P>0.05).The satisfaction of patients 3 months after surgery(Bostman functional score classification)was better in the suture bridge group than in the hollow screw gro
作者
金鹏鹏
柯友群
唐金兵
唐露露
湛梅圣
Jin Pengpeng;Ke Youqun;Tang Jinbing;Tang Lulu;Zhan Meisheng(Department of Orthopedics,Zaoyang First People's Hospital,Zaoyang Hubei,441200,China)
出处
《生物骨科材料与临床研究》
CAS
2024年第2期21-25,31,共6页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
胫骨结节撕脱性骨折
缝线桥技术
膝关节功能
骨折术后并发症
Avulsion fracture of tibial tubercle
Suture bridge technique
Knee function
Postoperative complications after the fracture
