关节镜下三点缝合治疗前交叉韧带胫骨止点撕脱骨折患者的效果分析OA
Effect Analysis of Arthroscopic Three-Point Suture in the Treatment of Patients with Anterior Cruciate Ligament Tibial Arrest Avulsion Fracture
目的:观察关节镜下三点缝合治疗前交叉韧带胫骨止点撕脱骨折患者的临床效果.方法:选择 2021年 8月—2024年 3月同济大学附属东方医院胶州医院收治的 100例前交叉韧带胫骨止点撕脱骨折患者为研究对象,按照随机信封法将其分为对照组(n=43)和研究组(n=57).对照组采用关节镜下钢丝内固定术治疗,研究组采用关节镜下三点缝合治疗.两组术后均观察 6个月.对比两组临床疗效、围手术期指标、关节功能、疼痛程度、并发症发生情况、创伤应激指标.结果:研究组临床治疗优良率为 98.25%,高于对照组的 86.05%,差异有统计学意义(P<0.05).两组住院时间、骨折愈合时间、术中出血量比较,差异均无统计学意义(P>0.05);研究组术后首次负重时间、手术时间均短于对照组,差异均有统计学意义(P<0.05).术后 6个月,两组国际膝关节文献委员会和Lysholm膝关节功能量表评分均高于术前,且研究组高于对照组,术后 7 d,两组疼痛视觉模拟法评分均低于术后3 d,且研究组低于对照组,差异均有统计学意义(P<0.05).术后 3 d,两组肾上腺皮质激素、醛固酮和皮质醇水平均高于术后 1 d,但研究组均低于对照组,差异均有统计学意义(P<0.05).研究组并发症发生率为 3.51%,低于对照组的 16.28%,差异有统计学意义(P<0.05).结论:在前交叉韧带胫骨止点撕脱骨折患者的临床治疗中,关节镜下三点缝合手术时间短且具有良好的治疗效果,能够进一步缓解患者术后创伤应激和疼痛程度,降低并发症发生率,改善关节功能,促进患者术后康复进程.
Objective:To observe the clinical effect of arthroscopic three-point suture in the treatment of patients with anterior cruciate ligament tibial arrest avulsion fracture.Methods:A total of 100 patients with anterior cruciate ligament tibial arrest avulsion fracture admitted to Jiaozhou Hospital Affiliated to Dongfang Hospital of Tongji University from August 2021 to March 2024 were selected as the study objects,and were divided into a control group(n=43)and a study group(n=57)according to random envelope method.The control group was treated with arthroscopic wire fixation,and the study group was treated with arthroscopic three-point suture.Both groups were observed for 6 months after operation.The clinical efficacy,perioperative indexes,joint function,pain degree,occurrence of the complications and traumatic stress indexes were compared between the two groups.Results:The excellent and good rate of clinical treatment in the study group was 98.25%,which was higher than 86.05%in the control group,the difference was statistically significant(P<0.05).There were no significant differences in hospitalization time,fracture healing time and intraoperative blood loss between the two groups(P>0.05).The first weight-bearing time after surgery and operation time of the study group were shorter than those of the control group,the differences were statistically significant(P<0.05).Six months after surgery,scores of International Knee Documentation Committee and Lysholm Knee Score in both groups were higher than before surgery,and the study group were higher than the control group,on day 7 after surgery,scores of Pain Visual Analogue Scales in both groups were lower than on day 3 after surgery,and the study group was lower than the control group,with statistical significance(P<0.05).The levels of adrenocortical hormone,aldosterone and cortisol in 2 groups were higher than those in 1 day after surgery,but the levels in the study group were lower than those in the control group,with statistical significance(P<0.05).The complication rate of the study group was 3.51%,which was lower than 16.28%of the control group,the difference was statistically significant(P<0.05).Conclusion:In the clinical treatment of patients with anterior cruciate ligament tibial arrest avulsion fracture,arthroscopic three-point suture has a short operation time and good therapeutic effect,which can further relieve the postoperative traumatic stress and pain degree of patients,reduce the incidence of complications,improve joint function,and promote the postoperative rehabilitation process of patients.
胡光蕾;臧高翔
同济大学附属东方医院胶州医院关节外科,山东 青岛 266000同济大学附属东方医院胶州医院关节外科,山东 青岛 266000
医药卫生
前交叉韧带胫骨止点撕脱骨折关节镜下钢丝固定关节镜下三点缝合关节功能并发症
Anterior cruciate ligament tibial arrest avulsion fractureWire fixation under arthroscopeArthroscopic three-point sutureJoint functionComplication
《中国伤残医学》 2025 (6)
10-14,5
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