關(guān)節(jié)鏡下帶螺紋克氏針張力帶鋼絲固定治療脛骨髁間嵴骨折的效果及優(yōu)勢

李慶標(biāo)　羅惠慈　戴冠東

【摘要】 目的：評價(jià)關(guān)節(jié)鏡下帶螺紋克氏針張力帶鋼絲固定治療脛骨髁間嵴骨折的效果及優(yōu)勢。

方法：抽選本院2017年1月-2018年6月收治的40例脛骨髁間嵴骨折患者病例資料進(jìn)行回顧分析，通過隨機(jī)數(shù)字表法分為對照組與觀察組，每組20例。對照組實(shí)施常規(guī)螺絲釘固定或高強(qiáng)線“8”字纏繞固定治療，觀察組實(shí)施關(guān)節(jié)鏡下帶螺紋克氏針張力帶鋼絲固定治療，對比兩組膝關(guān)節(jié)功能評分、膝關(guān)節(jié)優(yōu)良率、生活能力、生活質(zhì)量及并發(fā)癥發(fā)生率。結(jié)果：觀察組膝關(guān)節(jié)功能評分、膝關(guān)節(jié)優(yōu)良率、生活能力及生活質(zhì)量均高于對照組（P<0.05）;觀察組并發(fā)癥發(fā)生率低于對照組（P<0.05）。結(jié)論：在脛骨髁間嵴骨折臨床治療中，應(yīng)用關(guān)節(jié)鏡下帶螺紋克氏針張力帶鋼絲固定治療，不僅可以提高膝關(guān)節(jié)功能及膝關(guān)節(jié)恢復(fù)效果，還可以降低并發(fā)癥發(fā)生率，提高患者生活能力與生活質(zhì)量，臨床應(yīng)用價(jià)值較高，值得推廣。

【關(guān)鍵詞】 關(guān)節(jié)鏡; 帶螺紋克氏針張力帶鋼絲固定; 脛骨髁間嵴骨折

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-authors address：Pingshan District Peoples Hospital of Shenzhen，Shenzhen 518118，China

doi：10.3969/j.issn.1674-4985.2019.23.037

脛骨髁間嵴骨折是骨科常見病，其上由膝關(guān)節(jié)的暴力損傷后，致使前交叉韌帶止點(diǎn)出現(xiàn)撕脫性骨折，屬于關(guān)節(jié)內(nèi)骨折，易引起關(guān)節(jié)不穩(wěn)及功能障礙，也是目前創(chuàng)傷骨科一大重點(diǎn)難題[1]。臨床統(tǒng)計(jì)表明，脛骨髁間嵴骨折在全身骨折中占比0.5%，對患者生活質(zhì)量造成嚴(yán)重影響[2]。目前，在脛骨髁間嵴骨折臨床治療中，多采用內(nèi)固定治療方案。而骨折內(nèi)固定方式較多，不同方式效果不同，利弊各異，其中以切開復(fù)位鋼絲或螺釘固定、關(guān)節(jié)鏡下螺絲釘固定、關(guān)節(jié)鏡下高強(qiáng)線“8”纏繞固定法、前交叉韌帶重建術(shù)等，其中前者創(chuàng)傷大，而關(guān)節(jié)鏡下螺絲釘固定可能會損傷關(guān)節(jié)軟骨面及需二次取內(nèi)固定，關(guān)節(jié)鏡下高強(qiáng)線“8”纏繞固定法，步驟繁鎖、手術(shù)時(shí)間長、治療費(fèi)用，前交叉韌帶重建術(shù)需要取自體肌腱，損傷大、治療費(fèi)用高、術(shù)后恢復(fù)時(shí)間長等[3]。以上治療方案術(shù)后功能恢復(fù)時(shí)間長，均具有一定的局限性。臨床為提高脛骨髁間嵴骨折治療效果，對其實(shí)施深入研究，發(fā)現(xiàn)應(yīng)用關(guān)節(jié)鏡下帶螺紋克氏針張力帶鋼絲固定治療，不僅可以提高治療效果，還可以提高預(yù)后效果[4]。本次研究針對關(guān)節(jié)鏡下帶螺紋克氏針張力帶鋼絲固定治療脛骨髁間嵴骨折的療效及優(yōu)勢進(jìn)行評價(jià)，取40例脛骨髁間嵴骨折患者開展研究，現(xiàn)報(bào)道如下。