关节镜下双股缝线联合Endobutton固定与切开复位固定治疗后交叉韧带胫骨止点撕脱性骨折的疗效比较

Analysis and comparison of arthroscopic treatment of tibial avulsion fracture of posterior cruciate ligament with double thigh suture combined with Endobutton fixation and open reduction

摘要:

目的 比较关节镜下双股缝线联合Endobutton固定与切开复位固定治疗后交叉韧带胫骨止点撕脱性骨折的疗效。方法 回顾性分析2017年1月—2021年10月在湖南省人民医院集团澧县人民医院治疗的40例后交叉韧带胫骨止点撕脱性骨折患者的临床资料。根据手术方式不同分为关节镜组（20例）与切开复位组（20例）。比较两组患者术前及术后12个月膝关节IKDC评分、Lysholm评分，两组患者的手术时间、术中出血量、手术切口长度及住院时间。结果 两组手术均顺利完成，无血管神经损伤，术后伤口均一期愈合；关节镜组与切开复位组术后12个月IKDC膝关节评分分别为（93.67±2.07）、（92.16±3.18）分，均高于术前的（42.52±5.54）、（42.89±6.71）分（P <0.05）；关节镜组与切开复位组术后12个月Lysholm评分分别为（95.40±1.10）、（94.60±2.11）分，均高于术前的（36.75±6.63）、（37.35±6.43）分（P <0.05）；关节镜组术后12个月IKDC评分和Lysholm评分与切开复位组比较，差异无统计学意义（P >0.05）。关节镜组的手术时间、住院时间均短于切开复位组（P <0.05），术中出血量少于切开复位组（P <0.05），手术切口长度小于切开复位组（P <0.05）。结论 关节镜下双股缝线联合Endobutton固定治疗后交叉韧带胫骨止点撕脱性骨折比切开复位固定操作相对简易可行，安全、微创，膝关节功能恢复快。

Abstract:

Objective To compare the curative effect of arthroscopic fixation of tibial avulsion fracture of posterior cruciate ligament with double thigh suture combined with Endobutton and open reduction.Methods The clinical data of 40 patients with tibial avulsion fracture of posterior cruciate ligament treated by these two methods in Lixian People's Hospital of Hunan Provincial People's Hospital Group from January 2017 to October 2021 were analyzed retrospectively. The patients were divided into arthroscopy group (n = 20) and open reduction group (n = 20) according to the mode of operation. The knee joint IKDC score, Lysholm score, operation time, blood loss, incision length and hospital stay were compared before and 12 months after operation.Results The operations of the two groups were successfully completed without vascular nerve injury, and the postoperative wounds healed by first intention. The IKDC knee joint scores of the arthroscopic group and the open reduction group were (93.67 ± 2.07) points and (92.16 ± 3.18) points at 12 months after operation, respectively.) points, which were improved compared with (42.52 ± 5.54) points and (42.89 ± 6.71) points before operation (P < 0.05). The Lysholm knee function scores in the arthroscopic group and the open reduction group were (95.40 ± 1.10) and (94.60 ± 2.11) at 12 months after operation, which were higher than those before operation (36.75 ± 6.63) and (37.35 ± 6.43) (P < 0.05). There was no significant difference in the IKDC score and Lysholm score between the arthroscopic group and the open reduction group at 12 months after operation (P > 0.05). The operation time, blood loss, incision length, and hospital stay in the arthroscopic group were all shorter than those in the open reduction group (P < 0.05).Conclusion Arthroscopic fixation of tibial avulsion fracture of posterior cruciate ligament with double thigh suture combined with Endobutton has the advantages of relatively simple and feasible operation, safe and minimally invasive, and quick functional recovery of knee joint compared with open reduction and fixation.