空心加压螺钉加钢丝环扎及张力带治疗髌骨骨折  

Cannulated compression screws combined with circumferential loop and tension band wire for patellar fracture

作　　者：张弩[1] 刘登胜[1] 

机构地区：[1]武汉大学人民医院骨科,湖北省武汉市430060

出　　处：《中国组织工程研究与临床康复》2008年第9期1639-1642,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察应用骨科置入材料空心加压螺钉加钢丝环扎及张力带治疗髌骨骨折的疗效。方法:武汉大学人民医院骨科2001-05/2006-02应用空心加压螺钉加钢丝环扎及张力带治疗髌骨骨折24例,其中男15例,女9例;年龄18～60岁,平均32岁;髌骨横形骨折14例,粉碎性骨折10例,全部为闭合性骨折。手术时间为受伤后2～6h。分别于术后4,6,8,10周拍X射线片检查,观察材料及宿主反应。按陆裕朴等疗效评定标准进行功能评估。结果:22例患者获得随访,随访时间为4～24个月,平均10个月。其中1例随访4个月,5例随访6个月,5例随访8个月,4例随访10个月,3例随访12个月,2例随访14个月,1例随访18个月,1例随访24个月。①患膝X射线片评估:骨折解剖复位率达100%。切口均一期愈合。骨折愈合时间为4～10周,平均为6周。②疗效:优20例,良2例。③材料反应:术后内固定物未见腐蚀、松动、断裂。④宿主反应:待骨折愈合,内固定取出时,发现在钢丝接头处有囊膜形成。结论:空心加压螺钉加钢丝环扎及张力带内固定坚强可靠,无软组织刺激引起的疼痛及钢丝松动现象,是治疗髌骨骨折的理想方法。AIM： To observe the curative effect of internal fixation of patellar fracture by cannulated compression screws combined with circumferential loop and tension band wire. METHODS： From May 2001 to February 2006, 24 cases of patellar fracture treated with cannulated compression screws combined with circumferential loop and tension band wire were enrolled at Department of Orthopaedics, Renmin Hospital, Wuhan University. It involved 15 males and 9 females, averagely 32 years （18-60 years）. There were 14 cases of transverse fracture, 10 cases of comminuted fracture, and all cases were closed fracture. The operation was performed 2-6 hours after injury. X-ray was done at weeks 4, 6, 8 and 10 after operation respectively to observe the material and host reaction. Function was assessed by curative effect assessment criteria made by Lu et al. RESULTS： Totally 22 cases were followed-up. Follow-up period was 4 months to 24 months （mean 10 months）. One patient was followed up for 4 months, 5 cases for 6 months, 5 cases for 8 months, 4 cases for 10 months, 3 cases for 12 months, 2 cases for 14 months, 1 case for 18 months and 1 case for 24 months. （1）Reduction rate of fracture was 100%. Incision was primary healing. The fractures healed 4-10 weeks after operation, averagely 6 weeks. （2）Twenty patients had excellent curative effect, and two patients had good curative effect. （3）No corrosion, cinch and breakage were found after operation. （4）Peplos appeared at the junction of steel-wire when the fracture was healed. CONCLUSION： Cannulated compression screws combined with circumferential loop and tension band wire is the ideal implant for the patellar fracture. No pain or steel-wire cinch induced by soft tissue stimulation is found.

关 键 词：髌骨 骨折 内固定术 

分 类 号：R318[医药卫生—生物医学工程]