北京中安泰华科技有限公司临床试验专项（编号 ZATH-RF-T30-29-04）；泸州市科技创新苗子培育计划项目（编号 2020-RCM-65）；西南医科大学校级科研项目（编号 22020ZRQNB060）
The Affiliated Traditional Chinese Medicine Hospital of Southwest Medica
Special clinical trial of Beijing Zhongan Taihua Technology Co., Ltd. (No. zath-rf-t30-29-04); Luzhou science and technology innovation seedling cultivation plan project (No. 2020-rcm-65); School level scientific research project of Southwest Medical University (No. 22020zrqnb060)
[目的] 对比分析全镜下锚钉与空心螺钉固定在前交叉韧带（anterior cruciate ligament, ACL）胫骨撕脱骨折治疗中的临床效果。[方法] 对本院2012年6月~2018年6月因 ACL胫骨撕脱骨折在全镜下行固定修复的84例患者进行回顾性分析，其中锚钉固定修复44例（锚钉组），年龄18~52岁，平均（25.42±10.51）岁；空心螺钉固定修复40例（空心钉组），年龄19~55岁，平均（27.28±9.34）岁。记录两组手术时间、合并半月板损伤、下地行走时间等情况，对两组术后Tegner、Lysholm、国际膝关节文献委员会（IKDC）膝关节评分进行疗效随访评估。结果 84例患者均顺利随访，随访时间均超过18个月。锚钉组下地行走及完全负重活动时间均短于空心钉组，差异有统计学意义（P<0.05）。两组患者均随时间延长各膝关节评分显著增加，不同时间点间差异有统计学意义（P<0.05）；术后3个月，锚钉组各膝关节评分均优于空心钉组，差异有统计学意义（P<0.05）；余时间点两组间差异均无统计学意义（P>0.05）。锚钉组再次手术率显著低于空心钉组，差异有统计学意义（P<0.05）。随访期间，两组均未出现内固定物松动、感染及其他并发症。 结论 两种手术方式都取得良好的临床效果，与空心螺钉固定相比，锚钉固定具有骨折愈合时间短、前期疗效更佳及二次手术率显著降低等优势。
[Objective] To compare and analyze the clinical effect of total arthroscopic anchor and cannulated screw fixation in the treatment of tibial avulsion fracture of anterior cruciate ligament (ACL). [Methods] 84 patients with avulsion fracture of ACL tibia due to total arthroscopic fixation and repair in our hospital from June 2012 to June 2018 were retrospectively analyzed, including 44 cases ( anchor group) were fixed and repaired with anchor, aged 10 ~ 52 years, with an average of (25.42 ± 10.51) years; 40 cases (screw group) were fixed and repaired with cannulated screws, aged from 12 to 55 years, with an average of (27.28 ± 9.34) years. The operation time, combined meniscus injury and walking time were recorded. The postoperative joint relaxation and the knee score of Tegner, Lysholm and IKDC were followed up and evaluated. [Results] 84 patients were followed up successfully for more than 18 months. The time of walking and full weight-bearing activities in the anchor group were shorter than those in the screw group, and the difference was statistically significant (P < 0.05). The scores of knee joints in both groups increased significantly with the extension of time, and there was significant difference between different time points (P < 0.05); Three months after operation, the knee joint scores in the anchor group were better than those in the screw group (P < 0.05); There was no significant difference between the two groups at other time points (P > 0.05). The reoperation rate of anchor group was significantly lower than that of screw group (P < 0.05). During the follow-up, there were no internal fixation loosening, infection and other complications in both groups. [Conclusion] Both surgical methods have achieved good clinical results, Compared with cannulated screw fixation, row anchor fixation has the advantages of short fracture healing time, better early curative effect and significantly lower secondary operation rate.