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关节镜辅助下Orthcord缝线固定治疗胫骨髁间隆起骨折的临床疗效分析:一项回顾性比较队列研究

Clinical efficacy analysis of arthroscopically assisted orthcord suture fixation in the treatment of tibial intercondylar eminence fractures: a retrospective comparative cohort study.

作者信息

Zhang Rongfang, Wang Yuqi, Jia Xinyue, Qiao Yuanxin, Liu HongBo

机构信息

Department of Sports Medicine, Nanyang Traditional Chinese Medicine Hospital (Nanyang Orthopedic Hospital, NanYang, 473000, Henan, PR China.

Bone and joint trauma and Sports Medical Center, Yidu Central Hospital of Weifang, Weifang, ShangDong, PR China.

出版信息

Sci Rep. 2025 Jul 2;15(1):23575. doi: 10.1038/s41598-025-08979-z.

Abstract

To explore the efficacy of arthroscopically assisted fixation of type II and type III tibial intercondylar eminence fractures with Orthcord sutures. A retrospective analysis was performed on 80 patients with intercondylar eminence fractures admitted to our hospital from April 2020 to March 2023. According to different surgical methods, the patients were divided into special suture fixation group (n = 30), cannulated screw fixation group (n = 24), and wire fixation group (n = 26). The suture group used arthroscopic Orthcord sutures to fix tibial intercondylar eminence fractures, and the cannulated screw group used cannulated compression screws for fixation. Patients in the wire group underwent arthroscopic wire fixation. The basic information of all patients was collected and followed up for 1 year. The Lysholm score and Range of motion of the knee joint and was performed at 3 months and 1 year after surgery. The patients' general data, surgical conditions, operation time, blood loss, hospitalization costs, postoperative recovery (Lysholm score and Range of motion of knee joint and at 3 months and 1 year after surgery) and other data were analyzed by variance analysis. P < 0.05 was considered statistically significant. There was no statistical difference in the general data of all patients. One-year follow-up showed that all patients had achieved bone healing without displacement, or bone malformation. The hospitalization time in the wire group was (11 ± 1.02) days, the screw group was (11.58 ± 1.61) days, and the Orthcord suture group was shortened to (10.03 ± 1.07) days. The differences among the three groups were statistically significant (P < 0.05). At the same time, the cost of Orthcord suture surgery (1310.7 ± 0.29) $ was significantly lower than that of the other two groups (P<0.05). The operation time of the suture group (68.13 ± 1.11 min) was significantly shorter than that of the wire group (76.76 ± 11.57 min) and the screw group (90.62 ± 1.99 min) (P<0.05). In the follow-up, the score of Orthcord suture 3 months after operation (94.07 ± 2.72 points) was better than that of the wire group (90.23 ± 5.23 points) and the screw group (90.37 ± 5.41 points); the difference was statistically significant (P<0.05).Three months after surgery, the range of motion of the knee joint in the Orthcord suture group (124.8°±7.2°) was significantly better than that in the screw group (105.7°±9.3°) and the wire group (112.4°±8.6°) (P<0.05). However, there was no statistically significant difference in the Lysholm score of the three groups of patients 1 year after operation (96.26 ± 1.89, 96.33 ± 2.44, 97.3 ± 1.70) (P>0.05).Similarly, there was no significant difference in the range of knee motion among the three groups of patients 1 year after surgery (135.1°±4.2°), (134.6°±4.8°), and (136.3°±3.5°) (P>0.05).Late fixation fracture and chronic pain complications occurred in both the wire and screw groups, but not in the suture group. (P<0.05). The use of Orthcord sutures in the arthroscopically assisted treatment of intercondylar ridge fractures can shorten the length of hospital stay and surgery, while greatly reducing hospitalization costs. It can achieve better short-term (3 months) recovery effects while avoiding second surgery, and ultimately show no weaker fixation effect than conventional screws and wires when full weight-bearing is restored.

摘要

探讨采用Orthcord缝线在关节镜辅助下固定Ⅱ型和Ⅲ型胫骨髁间隆起骨折的疗效。对2020年4月至2023年3月我院收治的80例髁间隆起骨折患者进行回顾性分析。根据不同手术方法,将患者分为特殊缝线固定组(n = 30)、空心螺钉固定组(n = 24)和钢丝固定组(n = 26)。缝线组采用关节镜下Orthcord缝线固定胫骨髁间隆起骨折,空心螺钉组采用空心加压螺钉固定。钢丝组患者接受关节镜下钢丝固定。收集所有患者的基本信息并随访1年。在术后3个月和1年时进行膝关节Lysholm评分及活动度评估。对患者的一般资料、手术情况、手术时间、出血量、住院费用、术后恢复情况(术后3个月和1年时的Lysholm评分及膝关节活动度)等数据进行方差分析。P < 0.05被认为具有统计学意义。所有患者的一般资料无统计学差异。1年随访显示,所有患者均实现骨折愈合,无移位或骨畸形。钢丝组住院时间为(11 ± 1.02)天,螺钉组为(11.58 ± 1.61)天,Orthcord缝线组缩短至(10.03 ± 1.07)天。三组间差异有统计学意义(P < 0.05)。同时,Orthcord缝线手术费用(1310.7 ± 0.29)美元显著低于其他两组(P < 0.05)。缝线组手术时间(68.13 ± 1.11分钟)显著短于钢丝组(76.76 ± 11.57分钟)和螺钉组(90.62 ± 1.99分钟)(P < 0.05)。随访中,Orthcord缝线术后3个月评分(94.07 ± 2.72分)优于钢丝组(90.23 ± 5.23分)和螺钉组(90.37 ± 5.41分);差异有统计学意义(P < 0.05)。术后3个月,Orthcord缝线组膝关节活动度(124.8°±7.2°)显著优于螺钉组(105.7°±9.3°)和钢丝组(112.4°±8.6°)(P < 0.05)。然而,三组患者术后1年的Lysholm评分(96.26 ± 1.89、96.33 ± 2.44、97.3 ± 1.70)无统计学差异(P > 0.05)。同样,三组患者术后1年膝关节活动度(135.1°±4.2°)、(134.6°±4.8°)和(136.3°±3.5°)也无显著差异(P > 0.05)。钢丝组和螺钉组均出现了晚期骨折固定及慢性疼痛并发症,而缝线组未出现。(P < 0.05)。在关节镜辅助治疗髁间嵴骨折中使用Orthcord缝线可缩短住院时间和手术时间,同时大幅降低住院费用。它能在避免二次手术的情况下实现更好的短期(3个月)恢复效果,并且在恢复完全负重时最终显示出与传统螺钉和钢丝相比并不弱的固定效果。

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