髌骨骨折内固定方法的选择与并发症分析  

The selection of internal fixation method for patellar fracture and the analysis of its complications

作　　者：高明宏[1] 刘安庆[1] 鄢宏[1] 卢文浩[1] 谭纪锋[1] 黄晓阳[1] 

机构地区：[1]深圳市第二人民医院骨一科,广东深圳518035

出　　处：《医学信息（手术学分册）》2008年第6期487-489,共3页Medical Information Operations Sciences Fascicule

基　　金：深圳市科技计划项目资助(200603047)

摘　　要：目的通过对髌骨骨折术后并发症进行分析,探讨不同类型的髌骨骨折最佳固定方法。方法回顾性分析我科8年来髌骨骨折手术内固定病例332例,其中钢丝环扎73例,AO张力带固定105例,可吸收钉固定23例,Ni-Ti形状记忆合金聚髌器固定131例。根据术后6个月膝关节功能、X线表现进行综合评价,对比分析。结果332例患者均获随访,平均随访时间1.6年,发生各种并发症28例,其中钢丝环扎术后9例,AO张力带固定术后12例,可吸收钉固定术后3例,记忆合金聚髌器固定术后4例。其中再手术7例,所有骨折均临床愈合。结论髌骨骨折应根据骨折类型选择不同的内固定方式,髌骨骨折横断为两大块且无明显骨质疏松的患者可吸收钉固定可以做为一种较好的选择,Ni-Ti形状记忆合金聚髌器适用于各种类型髌骨骨折。Objective To explore the best fixation method of different types of patellar fractures by analysis of postoperative complications. Methods The retrospective analysis was done according to the information and records of the 332 patients with patellar fractures who had been cured in recent 8 years. Among these cases, there were 73 cases＇ steel wire fixations, 105 eases＇ AO - tension band fixation, 23 cases＇ poly - L - lactic acid screw fixation, and 131 eases＇ shape - remembering alloy claw fixing. The curative effects were judged by the functions of the patient＇s knee joints and the results of X - ray examinations in different periods after operation. Results The average followed up time was 1.6 years. Among the 332 patients, 28 cases were found postoperative complications, including 9 cases＇ steel wire fixation, 12 cases＇ AO - tension band fixation, 3 cases＇ poly - L - lactic acid screw fixation, and 4 cases＇ shape - remembering alloy claw fixation. Analysis and comparison of 4 types of fixation methods and the relevant curative effects were made. Conclusions The operation techniques should be chosen according to the types of fracture. Poly - L - lactic acid screw fixation method is fit for cross fracture without obvious osteoporosis, yet Ni - Ti shape - remembering alloy claw for all kinds of patella fracture.

关 键 词：髌骨骨折 AO张力带 可吸收钉 Ni—Ti形状记忆合金聚髌器 

分 类 号：R683.42[医药卫生—骨科学]