空心螺钉联合张力带内固定治疗青少年胫骨结节骨折的临床效果及对应激指标的影响OA
The Clinical Effect of Hollow Screw Combined with Tension Band Internal Fixation in the Treatment of Adolescent Tibial Tuberosity Fracture and Its Influence on Stress Indexes
目的:探析空心螺钉联合张力带内固定治疗青少年胫骨结节骨折(ATTF)的临床效果及对应激指标的影响.方法:回顾性选取鹰潭一八四医院 2023 年 2 月—2025 年 2 月收治的 113 例ATTF患者的临床资料,依据不同治疗方案分为观察组(57 例,空心螺钉联合张力带内固定治疗)和对照组(56 例,空心螺钉内固定治疗),比较两组Tegner活动评分、Lysholm评分、美国特种外科医院膝关节评分(HSS评分)、围手术期及术后恢复指标(术后初次膝关节活动度达 90°时间、术后初次可负重时间、住院时间)、应激指标[CRP、皮质醇(Cor)、前列腺素E2(PGE2)]及并发症(骺板早闭、内固定失效、切口感染、双下肢长度存在差异、骨折移位)发生情况.结果:观察组术后 1 个月Tegner活动评分、Lysholm评分及HSS评分高于对照组(P<0.05);观察组住院时间短于对照组,术后初次膝关节活动度达 90°时间、术后初次可负重时间早于对照组(P<0.05);观察组术后 3 d CRP、Cor及PGE2 水平低于对照组(P<0.05);观察组术后 1 个月内并发症发生率(1.75%)较对照组(12.50%)低(P<0.05).结论:空心螺钉联合张力带内固定治疗能加快ATTF患者膝关节功能恢复,缩短住院时间,减少应激反应与并发症发生.
Objective:To explore the clinical effect of hollow screw combined with tension band internal fixation in the treatment of adolescent tibial tuberosity fracture(ATTF)and its influence on stress indexes.Method:The clinical data of 113 patients with ATTF admitted to Yingtan 184 Hospital from February 2023 to February 2025 were retrospectively selected.According to different treatment methods,they were divided into observation group(57 cases,treated with hollow screw combined with tension band internal fixation)and control group(56 cases,treated with hollow screw internal fixation).The Tegner activity score,Lysholm score,Hospital for Special Surgery knee score(HSS score),perioperative and postoperative recovery indexes(time of the first postoperative knee joint activity reaching 90°,the first postoperative weight-bearing time,hospitalization time),stress indexes[CRP,cortisol(Cor),prostaglandin E2(PGE2)]and complications(early closure of epiphyseal plate,failure of internal fixation,incision infection,difference in length of lower limbs,fracture displacement)were compared between the two groups.Result:The Tegner activity score,Lysholm score and HSS score at 1 month after operation of the observation group were higher than those of the control group(P<0.05).The hospitalization time of the observation group was shorter than that of the control group,and the time of the first postoperative knee joint activity reaching 90° and the first postoperative weight-bearing time were earlier than those of the control group(P<0.05).The levels of CRP,Cor and PGE2 at 3 days after operation in the observation group were lower than those in the control group(P<0.05).Within 1 month after the operation,the incidence of complications in the observation group(1.75%)was lower than that in the control group(12.50%)(P<0.05).Conclusion:The internal fixation treatment of hollow screw combined with tension bands can accelerate the recovery of knee joint function in patients with ATTF,shorten the hospital stay,and reduce stress responses and the occurrence of complications.
李张;瞿年兵;郭金星;郑能方;孙琦;邱军荣
鹰潭一八四医院骨三科 江西 鹰潭 335000鹰潭一八四医院骨三科 江西 鹰潭 335000鹰潭一八四医院骨三科 江西 鹰潭 335000鹰潭一八四医院骨三科 江西 鹰潭 335000鹰潭一八四医院骨三科 江西 鹰潭 335000鹰潭一八四医院骨三科 江西 鹰潭 335000
医药卫生
张力带空心螺钉青少年胫骨结节骨折
Tension bandHollow screwAdolescent tibial tuberosity fracture
《中国医学创新》 2026 (19)
25-30,6
江西省2025年指导性科技计划项目(20255-211819)
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