| Objective:To compare the clinical effect of internal fixation with cannulated lag screws under knee arthroscope and traditional open operation internal fixation for the treatment of avulsion fracture of tibia intercondylar eminence and analyze the advantages and disadvantages of the two methods so as to provide better theoretical basis for the selection of the operative methods for the treatment of avulsion fracture of tibia intercondylar eminence.Methods:Retrospective study was done on 47 cases of avulsion fracture of tibia intercondylar eminence hospitalized in the Department of Orthopaedics in Yan’an University affiliated hospital from January 2012 to January 2015, of which 25 cases were treated with internal fixation with cannulated lag screws under knee arthroscope(treatment group), and 22 cases were treated with traditional open reduction and internal fixation(control group). According to Meyers and Mckeekver typing, operation time, the amount of bleeding in operation and hospital stays of each patient were recorded respectively, comparing and statistically analyzing the range of knee movement and Lysholm scoring scale of the two groups before and after operation, and 3 months after operation, and the postoperative complications of the two groups to evaluate the clinical effect of the two operative methods.Results: Clinical follow-up after operation shows that there was no significant difference in general data between the two groups(P>0.05). There was significant difference with the operation time of the treatment group(56.12±10.68min)and that of control group (75.45±12.43min)(P<0.05). There was statistic significance in the amount of bleeding in operation with treatment group(81.96±10.42ml)and control group(134.65±17.58ml)(P<0.05) and there was no statistic significance with the hospital stays of the treatment group(10.42±4.26d)and that of the control group(14.73±5.81d)(P>0.05). Comparison of the range of knee movement between the two groups before and after operation, and 3 months after operation: there was no statistic difference between the range of knee movement of treatment group before operation(1.43±2.78) and that of control group(34.81±2.64)(P>0.05);there was no statistic difference between the range of knee movement of treatment group after operation(87.74±4.65) and that of control group(85.42±5.26)(P>0.05);there was statistic difference between the range of knee movement of treatment group 3 months after operation(127.36±10.34) and that of control group(114.82±9.81)(P<0.05). For the treatment group, there was statistic significance before and after operation(P<0.05), and for the control group, there was also statistic significance before and after operation(P<0.05). Lysholm scoring scale before and after operation, 3 months after operation shows: a. For the treatment group, there was statistic significance with Lysholm scoring scale before(40.25±13.65)and after(84.71±12.43)operation, and follow-up 3 months after operation(92.68±6.73)(P<0.05); for the control group, there was also statistic significance with Lysholm scoring scale before(38.95±14.68) and after(80.69±14.52)operation, and follow-up 3 months after operation(85.64±4.75)(P<0.05). b. there was no statistic significance with Lysholm scoring scale before operation between treatment group and control group(P>0.05); there was still no statistic significance with Lysholm scoring scale after operation between treatment group and control group(P>0.05); there was statistic significance with Lysholm scoring scale 3 months after operation between the two groups(P<0.05). Comparison of the postoperative complications of the two groups: there was no postoperative infection and failure in internal fixation for the two groups; there were one case of postoperative pain, one case of postoperative anchylosis and one cases of complications for the treatment group making up 8.0% percent of the total; there were 4cases of postoperative pain, 3 cases of postoperative anchylosis and 7 cases of complications for the control group making up 31.82% percent of the total; by X2 inspection, there was significant difference with complication rate between the two groups(P<0.05).Conclusion: 1. For the patients of avulsion fracture of tibia intercondylar eminence, both internal fixation with cannulated lag screws under knee arthroscope and traditional open operation internal fixation can achieve satisfactory therapeutic effects. 2. The amount of bleeding in operation, operation time, Lysholm scoring scale and the range of knee movement after operation, the postoperative complications of the treatment group were superior to that of the control group. 3. Internal fixation with cannulated lag screws under knee arthroscope for the treatment of avulsion fracture of tibia intercondylar eminence has a satisfactory clinical effect, as it has the advantages of shorter operation time, stable internal fixation,early rehabilitation exercise after operation, reduction of anchylosis of knee joint and adhesion of local tissues. 4. Although statistical handling was made in the comparative analysis of patients being applied the two operation methods, the number of cases was small and it was limited to some extent to reflect the result accurately and overall. |
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