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全镜下单纯前入路与后内侧辅助入路治疗Meyers-McKeever Ⅱ型后交叉韧带胫骨侧止点撕脱骨折的临床对比研究
Clinical comparison between all-arthroscopic simple anterior approach and posteromedial adjuvant approach in the treatment of Meyers-McKeever type Ⅱ posterior cruciate ligament tibial avulsion fracture
投稿时间:2023-02-22  
DOI:10.3969/j.issn.1672-5972.2024.02.010
中文关键词:  全镜下  前入路  弹性固定  后交叉韧带胫骨侧止点撕脱骨折
英文关键词:All-arthroscopic  Anterior approach  Elastic fixation  Posterior cruciate ligament tibial avulsion fracture
基金项目:
作者单位邮编
李鹏 河北省保定市第一医院骨科河北 保定071000 071000
郝建学* 河北省保定市第一医院骨科河北 保定071000 071000
李正 河北省保定市第一医院骨科河北 保定071000 071000
刘根玮 河北省保定市第一医院骨科河北 保定071000 071000
杨斐 河北省保定市第一医院骨科河北 保定071000 071000
李辉 河北省保定市第一医院骨科河北 保定071000 071000
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中文摘要:
      目的 通过两种手术入路数据对比,探究全关节镜下单纯前入路和后内侧辅助入路弹性固定在治疗后交叉韧带胫骨侧止点撕脱骨折上是否存在差异。方法 通过回顾性分析2019年6月至2022年3月河北省保定市第一医院治疗的56例Meyers-Mckeever Ⅱ型后交叉胫骨侧止点撕脱骨折病例,分别采取全关节镜下单纯前入路(28例,单纯前入路组)和后内侧辅助入路(28例,后内侧辅助入路组),通过带袢钢板弹性固定治疗。对两组的手术时间,骨折愈合时间,术后2周、1个月、3个月、6个月膝关节Lysholm评分、数字分级量表(NRS)疼痛评分及日常生活能力(ADL)评分指标进行统计,比较两种手术入路的优良性。结果 两组均随访6个月,单纯前入路组的手术时间,术后2周、1个月、3个月的Lysholm评分、NRS疼痛评分及ADL评分优于后内侧辅助入路组,差异有统计学意义(P<0.05)。两组的骨折愈合时间和术后6个月的Lysholm评分、NRS疼痛评分、ADL评分比较,差异无统计学意义(P>0.05)。结论 全关节镜下单纯前入路弹性固定治疗Meyers-McKeever Ⅱ型后交叉韧带胫骨侧止点撕脱骨折,具有手术操作简单、手术时间短、术后痛苦小的优点。
英文摘要:
      Objective To compare the data of two surgical approaches and explore whether there is a difference in the treatment of posterior cruciate ligament tibial lateral insertion avulsion fractures between all-arthroscopic simple anterior approach with elastic fixation and posteromedial auxiliary approach.Methods By reviewing the 56 cases of Meyers-McKeever type Ⅱ posterior cruciate ligament tibial avulsion fractures treated in the First Hospital of Baoding City from June 2019 to March 2022, arthroscopic anterior approach (28 cases) and posteromedial auxiliary approach (28 cases) were adopted respectively, and treated by elastic fixation of steel plate with loops. The operation time, fracture healing time, 2 weeks, 1 month, 3 months, 6 months after surgery, Lysholm score, Statistics on the Numerical Grading Scale (NRS) pain score and ability to live (ADL) score confirmed the excellence of the surgical method.Results The results showed that both groups of data were followed up for 6 months, with 28 cases each. The operation time of the anterior approach fixation group, Lysholm score, NRS pain score and ADL score at 2 weeks, 1 month, and 3 months after surgery were better than those in the posterior internal adjuvant approach fixation group, and the difference was statistically significant (P<0.05). There was no significant difference in fracture healing time, Lysholm score, NRS pain score and ADL score at 6 months after surgery between the two groups (P>0.05).Conclusion The all-arthroscopic simple anterior approach elastic fixation for the treatment of Meyers-McKeever type Ⅱ posterior cruciate ligament tibal avulsion fracture has the advantages of simple operation, short operation time, low postoperative pain.
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