| Objective: To study and analyze the clinical effect of arthroscopic suture anchor system "X" fixation compared with hollow compression screw in the treatment of osteochondral fracture of lateral femoral condyle.Methods: Thirty-five patients with osteochondral fracture of external femoral condyle treated in our hospital from June 2015 to July 2019 were retrospectively analyzed.There were 29 patients,including 18 males and 11 females.There were 19 cases of acute injury of right knee and 10 cases of acute injury of left knee.According to different surgical treatment methods,the patients were divided into two groups: group A and group B.Group A was treated with "X" type fracture fixation technique of suture anchor system under arthroscopy,and group B was fixed with hollow compression bone screw and gasket under arthroscopy.There were 17 patients in group A,including 13 males and 4 females,aged 17(±3.5)years.In group A,there were 7 cases of lateral femoral condylar cartilage fracture with acute patellar dislocation(or subluxation),4 cases of patellar dislocation were accompanied by meniscus and/or collateral ligament injury;osteochondral fracture of lateral femoral condyle with meniscus and/or collateral ligament injury in 4 cases.There were 12 patients in group B,including 7 males and 5 females,aged 16(±4.7)years.In group B,there were 4 cases of femoral external condylar cartilage fracture with acute patellar dislocation(or subluxation),3 cases of patellar dislocation were accompanied by meniscus and/or collateral ligament injury;osteochondral fracture of lateral femoral condyle with meniscus and / or collateral ligament injury in 4 cases.There was no significant difference in sex,age and preoperative injury between group An and group B(P>0.05).There was no significant difference in the number of fracture types between group A and group B(P>0.05).The HSS knee joint function score and the excellent and good rate were statistically analyzed on the 3rd day,1 month,3 months and 6 months after operation.The second arthroscopic operation was performed,and the postoperative complications in the knee joint were statistically analyzed.Results: It was found that the length of operation was 91(±8.3)minutes in group A and 40(±6.0)minutes in group B.The time of operation in group A was significantly more than that in group B,and the difference was statistically significant(P<0.05).There was no significant difference in the HSS score on the3 rd day and one month after operation,but the HSS score in group A was significantly higher than that in group B at three and six months after operation,and the difference was statistically significant(P<0.05).Postoperative complications of knee joint: meniscus injury in group A 2 cases and group B 5cases;cartilage injury in group A 2 cases(in gradeⅠ-Ⅱ);group B 7 cases(5 cases in gradeⅠand 2 cases in gradeⅡ).Among them,there were 1 case of compound injury in group A and 4 cases of compound injury in group B.The incidence of knee joint complications in group A was lower than that in group B,and the difference was statistically significant(P<0.05).In the HSS score six months after operation,the excellent and good rate in groups A and B was 100%,and the excellent rate in group A was 15/17,and that in group B was 8/12,but P>0.05,there was no statistical significance.There was no obvious bleeding during and after operation,and there was no venous thrombosis of lower extremities,wound ulceration,non-healing and so on.One patient in group B had occasional knee joint pain one and a half years after operation,and the other patients had no obvious complaints of knee joint stiffness,limitation of movement and pain.Conclusion: 1.Suture anchor system is not only suitable for non-weightbearing area and weight-bearing area of lateral femoral condyle,but also for internal fixation of smaller bone pieces.compared with compression hollow screw fixation,this method can reduce postoperative complications and improve knee joint function to a certain extent.2.For different types of osteochondral fractures of the lateral condyle of femur,appropriate treatment methods should be selected to achieve better results. |
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