摘要
目的对比两种固定材料在前交叉韧带止点撕脱骨折(Knee anterior cruciate ligament avulsion fracture,KACLAF)关节镜手术中应用效果。方法选取我院106例KACLAF患者(2021年9月至2022年9月),随机分成A组(n=53)、B组(n=53)。2组均行关节镜手术,其中B组采用空心螺钉固定材料,A组采用双排锚钉交叉缝线固定材料。对比2组围术期指标(手术耗时、骨折愈合时间、术中失血量),术前、术后3个月、6个月视觉模拟评分法(Visual analogue scales,VAS)、国际膝关节评分委员会(International knee documentation committee,IKDC)评分、膝关节活动度、骨代谢[全段甲状旁腺素(Intact parathyroid hormone,iPTH)、骨钙素(Osteocalcin,OC)、β-胶原降解产物(Beta collagen degradation products,β-CTX)]水平,术前、术后1d、3d创伤应激因子[白细胞介素-1(Interleukin-1,IL-1)、白细胞介素-10(Interleukin-1,IL-10)、C反应蛋白(C reactive protein,CRP)]水平。结果A组骨折愈合时间较B组短(P<0.05);术后3个月、6个月与B组相比,A组VAS评分更低,IKDC评分更高(P<0.05);术后3个月、6个月与B组相比,A组膝关节活动度更高(P<0.05);术后3个月、6个月与B组相比,A组血清OC水平更高,iPTH、β-CTX水平更低(P<0.05);术后1d、3d与B组相比,A组血清IL-1、IL-10、CRP水平更低(P<0.05)。结论在KACLAF患者关节镜手术中,与空心螺钉固定材料相比,应用双排锚钉交叉缝线固定材料更利于患者术后骨折愈合,减轻疼痛感,改善膝关节活动度及膝关节功能,且对机体创伤应激影响更小。
Objective To compare the effects of two fixation materials in arthroscopic surgery for anterior cruciate ligament arrest avulsion fracture(KACLAF).Methods 106 patients with KACLAF in our hospital(from September 2021 to September 2022)were selected and randomly divided into group A(n=53)and group B(n=53).Both groups underwent arthroscopic surgery,in which group B used hollow screw fixation material and group A used double-row anchors with cross-stitch fixation material.The perioperative indexes(operation time,fracture healing time,intraoperative blood loss),visual analogue scales(VAS),International knee documentation committee(IKDC)scores,knee joint mobility,knee joint movement,and knee joint scores,knee mobility,bone metabolism[Intact parathyroid hormone(iPTH),Osteocalcin(OC),Beta collagen degradation products(β-CTX)]levels,preoperative and postoperative 1d and 3d traumatic stress factor[Interleukin-1(IL-1),IL-10,C reactive protein(CRP)]levels were compared between the two groups at 3 months and 6 months after the operation.Results The fracture healing time of group A was shorter than that of group B(P<0.05).At 3 and 6 months after surgery,VAS score of group A was lower and IKDC score was higher than that of group B(P<0.05).Compared with group B,group A had higher knee motion at 3 months and 6 months after surgery(P<0.05).Compared with group B,the serum OC level of group A was higher,and the levels of iPTH andβ-CTX were lower at 3 and 6 months after surgery(P<0.05).Compared with group B,serum levels of IL-1,IL-10 and CRP in group A were lower 1 and 3 days after surgery(P<0.05).Conclusion In arthroscopic surgery of KACLAF patients,compared with hollow screw fixation materials,the application of double-row anchor cross-suture fixation materials is more conducive to postoperative fracture healing,reduce pain,improve knee motion and knee function,and has less impact on the body traumatic stress.
作者
叶挺
张胜龙
张虎
YE Ting(Sports Medicine Department of Xinxiang Second People's Hospital,Xinxiang 453000,China)
出处
《牡丹江医学院学报》
2023年第5期49-53,共5页
Journal of Mudanjiang Medical University
关键词
双排锚钉交叉缝线
前交叉韧带止点撕脱性骨折
空心螺钉
并发症
double row anchor cross suture
Avulsion fracture of anterior cruciate ligament insertion
Hollow screw
complication
