■需要更多有关恢复伤前运动水平和患者报告的胫骨脊柱撕脱(TSA)骨折后结果的信息,这在8至12岁的儿童中最常见。
■要分析回归游戏/运动(RTP),主观的膝关节特异性恢复,与关节镜下复位螺钉内固定治疗TSA骨折后患者的生活质量比较。
■队列研究;证据水平,3.
■该研究包括2000年至2018年在4个机构通过切开复位骨缝合(n=32)或关节镜下复位螺钉固定(n=29)治疗的61例年龄<16岁的TSA骨折患者;所有患者均进行了至少24个月的随访(平均值±SD,87.0±47.1个月;范围,24-189个月)。患者完成了关于恢复损伤前运动能力的问卷,主观的膝关节特异性恢复,和健康相关的生活质量,并比较治疗组的结果。进行了单变量和多变量逻辑回归分析,以确定与未能恢复到损伤前运动水平相关的变量。
■患者平均年龄为11岁,男性占主导地位(57%)。与采用螺钉植入的关节镜检查相比,采用骨缝合的切开复位与较快的RTP时间相关(中位数,8.0周vs21.0周;P<.001)。切开复位与骨缝合术也与损伤前水平RTP失败的风险较低相关(调整后的比值比,6.4;95%CI,1.1-36.0;P=.035)。术后位移>3mm会增加损伤前水平RTP失败的风险,而与治疗组无关(调整后的比值比,15.2;95%CI,1.2-194.9;P=0.037)。治疗组之间的膝关节特异性恢复或生活质量没有差异。
■与关节镜螺钉固定相比,开放手术与骨缝合是治疗TSA骨折更可行的选择,因为它导致更快的RTP时间和更低的RTP失败率。精确的减少有助于改进RTP。
UNASSIGNED: More information is needed regarding return to preinjury sport levels and patient-reported outcomes after tibial spine avulsion (TSA) fracture, which is most common in children aged 8 to 12 years.
UNASSIGNED: To analyze return to play/sport (RTP), subjective knee-specific recovery, and quality of life in patients after TSA fracture treated with open reduction with osteosuturing versus arthroscopic reduction with internal screw fixation.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: This study included 61 patients <16 years old with TSA fracture treated via open reduction with osteosuturing (n = 32) or arthroscopic reduction with screw fixation (n = 29) at 4 institutions between 2000 and 2018; all patients had at least 24 months of follow-up (mean ± SD, 87.0 ± 47.1 months; range, 24-189 months). The patients completed questionnaires regarding ability to return to preinjury-level sports, subjective knee-specific recovery, and health-related quality of life, and results were compared between treatment groups. Univariate and multivariate logistic regression analyses were conducted to determine variables associated with failure to return to preinjury level of sport.
UNASSIGNED: The mean patient age was 11 years, with a slight male predominance (57%). Open reduction with osteosuturing was associated with a quicker RTP time than arthroscopy with screw implantation (median, 8.0 vs 21.0 weeks; P < .001). Open reduction with osteosuturing was also associated with a lower risk of failure to RTP at preinjury level (adjusted odds ratio, 6.4; 95% CI, 1.1-36.0; P = .035). Postoperative displacement >3 mm increased the risk of failure to RTP at preinjury level regardless of treatment group (adjusted odds ratio, 15.2; 95% CI, 1.2-194.9; P = .037). There was no difference in knee-specific recovery or quality of life between the treatment groups.
UNASSIGNED: Open surgery with osteosuturing was a more viable option for treating TSA fractures because it resulted in a quicker RTP time and a lower rate of failure to RTP as compared with arthroscopic screw fixation. Precise reduction contributed to improved RTP.