髌骨下极骨折的手术治疗现状  

CURRENT SITUATION OF SURGICAL TREATMENT OF INFERIOR POLAR FRACTURE OF PATELLA

作　　者：张兴琳[1] 陈旭[1] 姜俊杰[1] 贾培桐 周智勇[1] 孙涛[1] 刘绍贤[1] 

机构地区：[1]烟台市烟台山医院创伤骨科,山东烟台264001

出　　处：《中国修复重建外科杂志》2010年第4期492-495,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的阐述髌骨下极骨折治疗的进展,分析治疗现状,并探讨存在的问题及进一步研究方向。方法广泛查阅国内外有关髌骨骨折的文献,结合研究成果和临床经验,总结髌骨下极骨折的治疗方法。结果对髌骨下极骨折的手术治疗可分为保留髌骨完整和部分切除下极碎骨块两种。前者包括多种术式,如钢丝环扎内固定、张力带固定、镍钛-聚髌器内固定、篮网状钢板内固定、改良McLaughlin法、普迪思线网状固定等;后者是髌骨部分切除伸膝装置重建术。每种方式均有其优势和局限。结论虽然多数研究倾向于保留髌骨完整,但有研究证实部分切除骨块对膝关节功能无显著影响。实验获取所能切除的髌骨下极大小的安全范围及可接受的术后延长范围,对规范髌骨下极粉碎性骨折的治疗至关重要。Objective To investigate the advance in surgical treatment of inferior pole fracture of patella and to explore the existing problems and further research directions.Methods Domestic and foreign literature in recent years on patella fracture was extensively reviewed,the surgical treatment of inferior pole fracture of patella was summarized by combining the research findings with clinical experience.Results The surgical treatment of inferior pole of patella fractures included retaining the integrity of the patella and partial patellectomy of inferior pole of patella and extending knee installation reconstruction.There were kinds of ways to retain the integrity of the patella,such as circular wire fixation,tension band fixation,NiTi-patella concentrotor fixation,basket plate fixation,reforming McLaughlin way and polydioxanone suture net fixation;the latter category is partial patellectomy and extensor device reconstruction.Every surgical way had its advantages and limitations.Conclusion Most studies tend to retain the integrity of the patella,but some researches have shown that partial resection of inferior pole of patella had no significant effect on knee function.It is important to obtain the security excisional range and elongation range postoperative by experiment for regulating the treatment of comminuted fractures of inferior pole of patella.

关 键 词：髌骨下极骨折 手术治疗 髌骨 部分切除 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]