经皮穿刺与切开复位张力带固定治疗横断型髌骨骨折的比较  

A comparison between percutaneous and open reduction with tension band wiring for the treatment of transverse patella fractures

作　　者：颜登鲁[1] 李健[1] 高梁斌[1] 谭平先[1] 张在恒[1] 

机构地区：[1]广州医学院附属广州市第二人民医院骨科,广州510150

出　　处：《中国微创外科杂志》2005年第4期320-322,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：广东省科委重点攻关项目(99B06703G);广东省医学科研基金项目(A2004541)

摘　　要：目的比较经皮穿刺与切开复位张力带固定治疗横断型髌骨骨折的临床疗效. 方法采用前瞻性研究,将1997年～2003年收治的62例髌骨骨折患者随意分为两组,一组采用经皮穿刺张力带固定治疗(27例,其中克氏针钢丝张力带23例,空心钉张力带4例),另一组采用切开复位克氏针钢丝张力带固定治疗(35例).比较两组骨折愈合时间、骨折复位、关节活动度及膝关节功能. 结果所有病例随访6～48个月,两组均达到骨性愈合,膝关节功能优良率经皮组为88.9%(24/27),切开组为88.6%(31/35),无显著差异(χ2=0.000,P=1.000).骨折愈合时间经皮组早于切开组(χ2=6.581,P=0.037). 结论经皮穿刺张力带固定法治疗横断型髌骨骨折能够满足骨折愈合及功能恢复所需要的解剖复位和固定强度,损伤小,骨折愈合快,临床效果良好.Objective To compare clinical effects between percutaneous and open reduction by using tension band wiring for the treatment of transverse patella fractures. Methods A prospective study was carried out. A series of 62 cases of transverse patella fracture from 1997 to 2003 were divided into two groups: the Percutaneous Group (n=27) and the Open Group (n=35). The Percutaneous Group received percutaneous reduction with tension band fixation, including 23 cases of internal fixation by Kirschner-wire techniques and 4 cases of fixation through cannulated cancellous bone screws. The Open Group received open reduction with Kirschner wiring tension band fixation. The time to bone union, the reduction condition, the movement range and the function of the knee were compared between the two groups. Results All the cases were followed for 6~48 months. The bone union was achieved in both of groups. The rate of “good” or “excellent” knee functions was 88.9% in the Percutaneous Group (24/27) and 88.6% in the Open Group (31/35), respectively, without significant difference (χ2=0.000,P=1.000). The time to bone union was earlier in the Percutaneous Group than in the Open Group (χ2=6.581,P=0.037). Conclusions Percutaneous reduction with tension band fixation can offer good anatomic reduction and enough fixation strength to meet the requirements for bone union and function recovery in the treatment of transverse patella fractures, with minimal invasion, quick union and excellent clinical outcomes.

关 键 词：经皮穿刺 髌骨骨折 张力带 

分 类 号：R687.3[医药卫生—骨科学]