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关节镜下缝合固定联合后入路切开复位环板治疗后交叉韧带胫骨止点撕脱骨折的临床疗效:一项回顾性研究。

Clinical outcomes of arthroscopic suture fixation combined with loop plate . posterior approach open reduction and cannulated screw fixation for treating tibial avulsion fractures of the posterior cruciate ligament: a retrospective study.

机构信息

Department of Emergency Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China.

Department of Orthopedic, Northern Jiangsu People's Hospital (NJPH), Yangzhou, China.

出版信息

PeerJ. 2024 Nov 15;12:e18532. doi: 10.7717/peerj.18532. eCollection 2024.

Abstract

BACKGROUND

Comparison of the efficacy of arthroscopic suture fixation combined with loop plate . the posterior approach involving open reduction and intramedullary nail fixation in treating posterior cruciate ligament tibial avulsion fractures (PCLTAFs).

METHODS

A retrospective analysis was conducted on the clinical data of patients diagnosed with PCLTAF who were admitted to Northern Jiangsu People's Hospital between June 2019 and March 2022. Based on distinct surgical procedures, the patients were categorized into two groups: arthroscopic group (33 cases), involving a single bone tunnel, high-strength suture, loop plate, and anchor screw fixed under arthroscopy, and open reduction and internal fixation (ORIF) group (13 cases), involving a modified posterior medial approach and fixation using 1-2 cannulated screws. Key parameters, including surgical duration, postoperative fracture alignment, fracture-healing duration, range of motion changes, postoperative Lysholm scores, and VAS scores were documented and compared between the two groups.

RESULTS

The study cohort comprised 46 patients, with 28 males and 18 females, and the median age was 29 years old (range: 15-69). There were no significant differences in the baseline characteristics, including knee Lysholm scores, between the two groups. The arthroscopic group exhibited significant improvement in all eight Lysholm score indicators (all < 0.001). The total Lysholm score also exhibited significant improvement before and after surgery in both groups ( < 0.001). Following surgery, the arthroscopic group demonstrated improvements in all indicators, but had a slightly longer operating time compared to the ORIF group. No significant differences were observed in the Lysholm scores for the knee joint between the two patient groups before and after surgery ( > 0.05).

CONCLUSIONS

Arthroscopic suture fixation in conjunction with looped plate binding can significantly improve knee function and clinical effect for patients in the treatment of PCLTAF, promotingearly postoperative functional recovery of patients.

摘要

背景

关节镜下缝合固定结合环扎钢板与后入路切开复位髓内钉内固定治疗后交叉韧带胫骨止点撕脱骨折(PCLTAF)的疗效比较。

方法

回顾性分析 2019 年 6 月至 2022 年 3 月在苏北人民医院收治的 PCLTAF 患者的临床资料。根据不同的手术方式将患者分为两组:关节镜组(33 例),采用单骨隧道、高强缝线、环扎钢板和锚钉固定;切开复位内固定(ORIF)组(13 例),采用改良后内侧入路,1-2 枚空心钉固定。记录并比较两组患者的手术时间、术后骨折对线、骨折愈合时间、关节活动度变化、术后 Lysholm 评分和 VAS 评分等关键参数。

结果

本研究共纳入 46 例患者,其中男 28 例,女 18 例,中位年龄 29 岁(15-69 岁)。两组患者的基线特征,包括膝关节 Lysholm 评分,差异均无统计学意义。关节镜组的所有 8 项 Lysholm 评分指标均明显改善(均 < 0.001)。两组患者术后的膝关节 Lysholm 评分均明显提高(均 < 0.001)。术后关节镜组各指标均有所改善,但手术时间较 ORIF 组略长。两组患者术前和术后的膝关节 Lysholm 评分差异均无统计学意义(> 0.05)。

结论

关节镜下缝线固定联合环扎钢板固定可明显改善 PCLTAF 患者的膝关节功能和临床疗效,促进患者术后早期功能恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a928/11572384/6bc95a34ca4e/peerj-12-18532-g001.jpg

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