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[1]邢寶瑞,韓廣普,臧建成,等.3種手術(shù)入路治療后交叉韌帶脛骨 止點(diǎn)撕脫骨折的療效比較[J].中醫(yī)正骨,2011,23(09):9-11.
　XING Bao-rui*,HAN Guang-pu,ZANG Jian-cheng,et al.Comparison of curative effects of three kinds of surgical approaches for tibial avulsion fracture of posterior cruciate ligament[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(09):9-11.
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3種手術(shù)入路治療后交叉韌帶脛骨 止點(diǎn)撕脫骨折的療效比較()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期數(shù):
2011年09期
頁碼:
9-11
欄目:
臨床研究
出版日期:
2011-09-30

文章信息/Info

Title:
Comparison of curative effects of three kinds of surgical approaches for tibial avulsion fracture of posterior cruciate ligament
作者:
邢寶瑞; 韓廣普; 臧建成; 袁福祿; 陳超
河北省滄州中西醫(yī)結(jié)合醫(yī)院,河北 滄州 061001
Author(s):
XING Bao-rui*; HAN Guang-pu; ZANG Jian-cheng; et al.*
Cangzhou Hospital of Integrated Traditional Chinese Medicine with Western Medicine of Hebei Province,Cangzhou 061001,Hebei,China
關(guān)鍵詞:
后交叉韌帶 膝關(guān)節(jié) 關(guān)節(jié)鏡檢查 治療; 臨床研究性
Keywords:
Posterior cruciate ligament;  Knee joint;  Arthroscopy;  Therapies; investigational
摘要:
目的:比較常規(guī)腘部“S”形切口入路、腘窩后內(nèi)側(cè)小切口入路及關(guān)節(jié)鏡下治療后交叉韌帶脛骨止點(diǎn)撕脫骨折的臨床療效 。方法:2009年4月至2010年6月,我院收治的后交叉韌帶脛骨止點(diǎn)撕脫骨折患者中病歷資料完整者共98例,其中采用常規(guī)腘部“S ”形切口入路者31例(Ⅰ組),關(guān)節(jié)鏡下治療者34例(Ⅱ組),腘窩后內(nèi)側(cè)小切口入路者33例(Ⅲ組)。記錄并比較各組患者的手術(shù)時 間、切口長度、術(shù)中出血量及血管神經(jīng)損傷情況。所有患者均于術(shù)后6個月按照Lysholm膝關(guān)節(jié)評分標(biāo)準(zhǔn)進(jìn)行療效評定。95～100 分為優(yōu),84～94分為良,<84分為可。結(jié)果:①術(shù)中指標(biāo)。3組患者手術(shù)時間比較,差異有統(tǒng)計(jì)學(xué)意義(F=94.062,P=0.000); Ⅰ組 患者比其他2組患者手術(shù)時間長(P=0.000; P=0.000); Ⅱ、Ⅲ組患者手術(shù)時間比較,差異無統(tǒng)計(jì)學(xué)意義(P=0.072)。3組患者切口 長度比較,差異有統(tǒng)計(jì)學(xué)意義(F=831.283,P=0.000); Ⅰ組患者切口長度比其他2組患者長(P=0.000; P=0.000); Ⅱ、Ⅲ組患者切 口長度比較,差異無統(tǒng)計(jì)學(xué)意義(P=0.803)。3組患者術(shù)中出血量比較,差異有統(tǒng)計(jì)學(xué)意義(F=77.814,P=0.000); Ⅰ組患者術(shù)中出 血量比其他2組患者多(P=0.000; P=0.000),Ⅱ、Ⅲ組患者術(shù)中出血量比較,差異無統(tǒng)計(jì)學(xué)意義(P=0.263)。3組患者血管神經(jīng)損傷 情況比較,差異有統(tǒng)計(jì)學(xué)意義(P=0.003); 組間兩兩比較,調(diào)整檢驗(yàn)水準(zhǔn)α=0.05/3=0.016,Ⅰ組發(fā)生血管神經(jīng)損傷的患者比例比其 他2組高(P=0.011; P=0.012),Ⅱ、Ⅲ組發(fā)生血管神經(jīng)損傷的患者比例,差異無統(tǒng)計(jì)學(xué)意義(P=1.000)。②Ⅱ、Ⅲ組療效優(yōu)于Ⅰ組 (Z=-2.598,P=0.009; Z=-2.503,P=0.012),Ⅱ、Ⅲ組療效差異無統(tǒng)計(jì)學(xué)意義(Z=-0.101,P=0.920)。結(jié)論:在手術(shù)治療后交叉韌帶 脛骨止點(diǎn)撕脫骨折時,腘窩后內(nèi)側(cè)小切口入路和關(guān)節(jié)鏡下治療比常規(guī)腘部“S”形切口入路具有明顯的優(yōu)勢。
Abstract:
Objective:To compare the curative effects of the 3 methods as conventional S-shaped incision into the popliteal parts,small incision into the posteromedial popliteal fossa and arthroscopic treatment for tibial avulsion fracture of posterior cruciate ligament(PCL).Methods:Ninety-eight cases with complete medical records were selected from the patients with tibial avulsion fracture of PCL treated in our hospital from April 2009 to June 2010.Thirty-one cases in groupⅠwere administrated with conventional S-shaped incision into the popliteal parts,34 cases in groupⅡwere administrated with arthroscopic treatment,while the others in groupⅢwere administrated with small incision into the posteromedial popliteal fossa.The operation time,incision length,amount of blood loss and situations of the neurovascular injury of the patients were recorded and compared among the 3 groups.Six months after the operation,the curative effects of all the patients were evaluated according to Lysholm knee joint scoring standards.Scores ranged from 95 to 100 were considered as excellent,scores ranged from 84 to 94 were considered as good,while the scores less than 84 were considered as fair.Results:①Intraoperative index:There was statistical difference in the operation time,incision length and amount of blood loss among the 3 groups(F=94.062,P=0.000; F=831.283,P=0.000; F=77.814,P=0.000); and the operation time of groupⅠwas longer than that of the other 2 groups(P=0.000; P=0.000),so does the incision length and amount of blood loss; while there was no statistical difference between groupⅡand groupⅢin above indices(P=0.072; P=0.803; P=0.263).There was statistical difference in the situations of the neurovascular injury among the 3 groups(P=0.003).According to adjusted size of test(α=0.05/3=0.016),the proportion of patients with neurovascular injury in groupⅠwas higher than that in the other 2 groups(P=0.011; P=0.012),while there was no statistical difference between groupⅡand groupⅢ(P=1.000).②The curative effects of groupⅡand groupⅢwere better than that of groupⅠ(Z=-2.598,P=0.009; Z=-2.503,P=0.012),and there were no statistical difference in the curative effects between groupⅡand groupⅢ(Z=-0.101,P=0.920).Conclusion:The method of small incision into the posteromedial popliteal fossa and the arthroscopic treatment have some obvious advantages over the method of conventional S-shaped incision into the popliteal parts in the surgical treatment for tibial avulsion fracture of PCL.

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備注/Memo

備注/Memo:
2010-09-16收稿 2011-01-11修回
更新日期/Last Update: 2011-09-30