关节镜下带螺纹克氏针张力带钢丝固定治疗胫骨髁间嵴骨折的效果及优势(1)
【摘要】 目的：评价关节镜下带螺纹克氏针张力带钢丝固定治疗胫骨髁间嵴骨折的效果及优势。
方法：抽选本院2017年1月-2018年6月收治的40例胫骨髁间嵴骨折患者病例资料进行回顾分析，通过随机数字表法分为对照组与观察组，每组20例。对照组实施常规螺丝钉固定或高强线“8”字缠绕固定治疗，观察组实施关节镜下带螺纹克氏针张力带钢丝固定治疗，对比两组膝关节功能评分、膝关节优良率、生活能力、生活质量及并发症发生率。结果：观察组膝关节功能评分、膝关节优良率、生活能力及生活质量均高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论：在胫骨髁间嵴骨折临床治疗中，应用关节镜下带螺纹克氏针张力带钢丝固定治疗，不仅可以提高膝关节功能及膝关节恢复效果，还可以降低并发症发生率，提高患者生活能力与生活质量，临床应用价值较高，值得推广。
【关键词】 关节镜; 带螺纹克氏针张力带钢丝固定; 胫骨髁间嵴骨折
Effect and Advantages of Arthroscopic Threaded Kirschner Wire Tension band Fixation for the Treatment of Humeral Intercondyle Fracture/LI Qingbiao，LUO Huici，DAI Guandong.//Medical Innovation of China，2019，16(23)：-149
【Abstract】 Objective：To evaluate the efficacy and advantages of arthroscopic threaded kirschner wire tension band fixation in the treatment of humeral intercondyle fractures.Method：The data of 40 patients with humeral intercondylar fractures from January 2017 to June 2018 were selected for retrospective analysis.The patients were divided into control group and observation group by random number table method，20 cases in each group.The control group was treated with conventional screw fixation or high-strength line“8”-wrapped fixation.The observation group was treated with arthroscopic threaded kirschner wire tension band wire fixation.The knee joint function score，knee joint excellent rate，living ability，quality of life and complication rate were compared between the two groups.Result：Knee joint function score，knee joint excellent rate，living ability and quality of life in the observation group were higher than those in the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).Conclusion：In the clinical treatment of humeral intercondylar fractures，the use of arthroscopic threaded kirschner wire tension band wire fixation can not only improve knee function and knee recovery，but also reduce the incidence of complications and improve patients’ living ability and quality of life，it has high clinical value and worth promoting.
【Key words】 Arthroscopy; Threaded kirschner wire tension band wire fixation; Humeral intercondylar fractures
First-author’s address：Pingshan District People’s Hospital of Shenzhen，Shenzhen 518118，China
doi：10.3969/j.issn.1674-4985.2019.23.037
脛骨髁间嵴骨折是骨科常见病，其上由膝关节的暴力损伤后，致使前交叉韧带止点出现撕脱性骨折，属于关节内骨折，易引起关节不稳及功能障碍，也是目前创伤骨科一大重点难题[1]。临床统计表明，胫骨髁间嵴骨折在全身骨折中占比0.5%，对患者生活质量造成严重影响[2]。目前，在胫骨髁间嵴骨折临床治疗中，多采用内固定治疗方案。而骨折内固定方式较多，不同方式效果不同，利弊各异，其中以切开复位钢丝或螺钉固定、关节镜下螺丝钉固定、关节镜下高强线“8”缠绕固定法、前交叉韧带重建术等，其中前者创伤大，而关节镜下螺丝钉固定可能会损伤关节软骨面及需二次取内固定，关节镜下高强线“8”缠绕固定法，步骤繁锁、手术时间长、治疗费用，前交叉韧带重建术需要取自体肌腱，损伤大、治疗费用高、术后恢复时间长等[3]。以上治疗方案术后功能恢复时间长，均具有一定的局限性。临床为提高胫骨髁间嵴骨折治疗效果，对其实施深入研究，发现应用关节镜下带螺纹克氏针张力带钢丝固定治疗，不仅可以提高治疗效果，还可以提高预后效果[4]。本次研究针对关节镜下带螺纹克氏针张力带钢丝固定治疗胫骨髁间嵴骨折的疗效及优势进行评价，取40例胫骨髁间嵴骨折患者开展研究，现报道如下。, http://www.100md.com(李庆标 罗惠慈 戴冠东)
方法：抽选本院2017年1月-2018年6月收治的40例胫骨髁间嵴骨折患者病例资料进行回顾分析，通过随机数字表法分为对照组与观察组，每组20例。对照组实施常规螺丝钉固定或高强线“8”字缠绕固定治疗，观察组实施关节镜下带螺纹克氏针张力带钢丝固定治疗，对比两组膝关节功能评分、膝关节优良率、生活能力、生活质量及并发症发生率。结果：观察组膝关节功能评分、膝关节优良率、生活能力及生活质量均高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论：在胫骨髁间嵴骨折临床治疗中，应用关节镜下带螺纹克氏针张力带钢丝固定治疗，不仅可以提高膝关节功能及膝关节恢复效果，还可以降低并发症发生率，提高患者生活能力与生活质量，临床应用价值较高，值得推广。
【关键词】 关节镜; 带螺纹克氏针张力带钢丝固定; 胫骨髁间嵴骨折
Effect and Advantages of Arthroscopic Threaded Kirschner Wire Tension band Fixation for the Treatment of Humeral Intercondyle Fracture/LI Qingbiao，LUO Huici，DAI Guandong.//Medical Innovation of China，2019，16(23)：-149
【Abstract】 Objective：To evaluate the efficacy and advantages of arthroscopic threaded kirschner wire tension band fixation in the treatment of humeral intercondyle fractures.Method：The data of 40 patients with humeral intercondylar fractures from January 2017 to June 2018 were selected for retrospective analysis.The patients were divided into control group and observation group by random number table method，20 cases in each group.The control group was treated with conventional screw fixation or high-strength line“8”-wrapped fixation.The observation group was treated with arthroscopic threaded kirschner wire tension band wire fixation.The knee joint function score，knee joint excellent rate，living ability，quality of life and complication rate were compared between the two groups.Result：Knee joint function score，knee joint excellent rate，living ability and quality of life in the observation group were higher than those in the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).Conclusion：In the clinical treatment of humeral intercondylar fractures，the use of arthroscopic threaded kirschner wire tension band wire fixation can not only improve knee function and knee recovery，but also reduce the incidence of complications and improve patients’ living ability and quality of life，it has high clinical value and worth promoting.
【Key words】 Arthroscopy; Threaded kirschner wire tension band wire fixation; Humeral intercondylar fractures
First-author’s address：Pingshan District People’s Hospital of Shenzhen，Shenzhen 518118，China
doi：10.3969/j.issn.1674-4985.2019.23.037
脛骨髁间嵴骨折是骨科常见病，其上由膝关节的暴力损伤后，致使前交叉韧带止点出现撕脱性骨折，属于关节内骨折，易引起关节不稳及功能障碍，也是目前创伤骨科一大重点难题[1]。临床统计表明，胫骨髁间嵴骨折在全身骨折中占比0.5%，对患者生活质量造成严重影响[2]。目前，在胫骨髁间嵴骨折临床治疗中，多采用内固定治疗方案。而骨折内固定方式较多，不同方式效果不同，利弊各异，其中以切开复位钢丝或螺钉固定、关节镜下螺丝钉固定、关节镜下高强线“8”缠绕固定法、前交叉韧带重建术等，其中前者创伤大，而关节镜下螺丝钉固定可能会损伤关节软骨面及需二次取内固定，关节镜下高强线“8”缠绕固定法，步骤繁锁、手术时间长、治疗费用，前交叉韧带重建术需要取自体肌腱，损伤大、治疗费用高、术后恢复时间长等[3]。以上治疗方案术后功能恢复时间长，均具有一定的局限性。临床为提高胫骨髁间嵴骨折治疗效果，对其实施深入研究，发现应用关节镜下带螺纹克氏针张力带钢丝固定治疗，不仅可以提高治疗效果，还可以提高预后效果[4]。本次研究针对关节镜下带螺纹克氏针张力带钢丝固定治疗胫骨髁间嵴骨折的疗效及优势进行评价，取40例胫骨髁间嵴骨折患者开展研究，现报道如下。, http://www.100md.com(李庆标 罗惠慈 戴冠东)