关节镜辅助下经皮中空螺丝钉加张力带法治疗髌骨横骨折  

Treatment of transverse fracture of patella with percutaneous hollow screw combined with tension band with arthroscope aid

作　　者：牛建军[1] 马迅[1] 纪斌平[1] 赵斌[1] 田江花[1] 

机构地区：[1]吕梁市人民医院,山西吕梁033000

出　　处：《中国骨伤》2006年第3期140-141,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨髌骨横骨折在关节镜下复位、中空螺丝钉加张力带法固定的治疗效果。方法:12例新鲜髌骨横骨折患者通过关节镜清理关节腔内的血凝块、碎骨块和骨折块之间嵌顿的软组织,直视下观察骨折复位情况以指导骨折复位固定,在C形臂X线透视下帮助骨折复位,关节镜观察关节面解剖复位后,经皮从近折端向远折端平行打入2枚克氏针固定骨折块,顺克氏针拧入2枚中空螺钉,拔除克氏针,顺螺钉空心导入钢丝,行张力带“8”字固定。结果:平均随访12.4个月,骨折愈合时间最短6周,最长10周,平均7.6周。根据Lysholm膝关节评分标准,优10例,良1例,尚可1例,优良率达91.67%。结论:关节镜辅助下经皮中空螺丝钉加张力带法治疗髌骨横骨折具有手术创伤小、关节面复位好、固定坚强、能早期功能锻炼、住院时间短、功能恢复快和合并症少等优点,为治疗新鲜髌骨横骨折提供了一种新的治疗方法。Objective：To apply arthroscope to the treatment of transverse fracture of patella with percutaneous hollow screw combined with tension band, and to explore its therapeutic effects. Methods： Twelve patients with fresh transverse fracture of patella were reviewed in the study. The hemarthrosis, blood clot, fracture fragments and soft tissues between them were cleared with arthroscopy. With the help of C-arm X-ray, the fracture was reduced with manipulation method. After the articular facet reached anatomical reduction, two Kirsehners were inserted pereutaneously from proximal end to distal end of fracture to fix the fragments, Two hollow screw were put along the approach of Kirschners, and tension band fixation was performed with the shape of ＂8＂. Results：All the patients were followed up averagely 12.4 months. The period of fracture healing ranged from 6 to 10 weeks, meanly 7.6 weeks. According to Lysholm＇s criterion, 10 patients reached excellent results, 1 good and 1 fair. The excellent-and-good rate was 91.67%. Conclusion： This treatment method has advantages as follows： mini-wound, good reduction of articular facet, strong fixation, early exercises, shorter length of stay, rapid recovery of function and few complications, which provided a new method to treat fresh transverse fracture of patella.

关 键 词：髌骨 骨折 关节镜手术操作 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学] R683[医药卫生—外科学]