Sun Kai, Fan Meng
Orthopaedic of Tianjin First Central Hospital, Tianjin, China.
Front Surg. 2023 Jan 13;9:887010. doi: 10.3389/fsurg.2022.887010. eCollection 2022.
The posterior cruciate ligament (PCL) plays an important role in maintaining the stability of the knee joint. To date, researchers have not reached agreement on which type of fixation material should be used to treat PCL tibial avulsion fractures. The aim of this study was to investigate the effects of double button plate and cannulated screw fixation in the treatment of PCL avulsion fractures.
We retrospectively reviewed our database, which was collected prospectively. From January 2019 to January 2020, 46 patients with posterior cruciate ligament avulsion fractures who were treated with double button plate and cannulated screw fixation. The primary outcomes of this study were surgical complications (fixation failure/displacement, implant breakage, nonunion, infection), radiological parameters, and knee function and secondary outcomes included reoperation rates for the fixation methods and the prevalence of symptomatic hardware causing soft tissue irritation outcomes were included. Values were analysed using multiple comparisons, where -values of 0.05 or less were considered significant.
Double button plate fixation had significantly higher values than cannulated screw fixation. The results showed that double button plate fixation was related to greater decreases in the length of surgery, intraoperative blood loss, hospital days, full weight bearing time, and incidence of complications, as well as greater increases in postoperative range of motion and Knee Society Score function and Lysholm scores.
Compared with cannulated screw fixation, the use of double button plate fixation technology has the following advantages: less trauma, shorter operation time, convenient use of instruments and fixtures, and it does not need to be removed, thus avoiding secondary trauma. Moreover, double button plate fixation under direct vision is safe and reliable without the need for additional equipment.
后交叉韧带(PCL)在维持膝关节稳定性方面起着重要作用。迄今为止,研究人员对于应使用哪种类型的固定材料来治疗PCL胫骨撕脱骨折尚未达成共识。本研究的目的是探讨双纽扣钢板和空心螺钉固定在治疗PCL撕脱骨折中的效果。
我们回顾性分析了前瞻性收集的数据库。2019年1月至2020年1月期间,46例后交叉韧带撕脱骨折患者接受了双纽扣钢板和空心螺钉固定治疗。本研究的主要结局指标为手术并发症(固定失败/移位、植入物断裂、骨不连、感染)、影像学参数和膝关节功能,次要结局指标包括固定方法的再次手术率以及引起软组织刺激的有症状内植物的发生率。采用多重比较分析数据,P值小于或等于0.05被认为具有统计学意义。
双纽扣钢板固定的各项数值显著高于空心螺钉固定。结果显示,双纽扣钢板固定与手术时间缩短、术中出血量减少、住院天数减少、完全负重时间缩短以及并发症发生率降低相关,同时术后活动范围、膝关节协会评分功能和Lysholm评分增加幅度更大。
与空心螺钉固定相比,使用双纽扣钢板固定技术具有以下优点:创伤小、手术时间短、器械和固定装置使用方便,且无需取出,从而避免了二次创伤。此外,直视下双纽扣钢板固定安全可靠,无需额外设备。