改良张力带与髌骨爪置入治疗髌骨骨折:同一机构7年230例资料比较  

Modified tension-band wire and memory alloy patellar holder in treatment of patellar fracture:Comparison in 230 cases from one institute within 7 years

作　　者：王维山[1] 董金波[1] 何斌[1] 杨坚[1] 史晨辉[1] 

机构地区：[1]石河子大学医学院第一附属医院骨一科,新疆维吾尔自治区石河子市832008

出　　处：《中国组织工程研究与临床康复》2010年第43期8145-8148,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:目前临床治疗髌骨骨折的内固定材料众多,但临床结果差异较大。如何选择适合中国医疗条件,疗效肯定,操作可行的材料仍然是临床需要解决的重要问题。目的:比较改良张力带与髌骨爪置入治疗髌骨骨折的疗效,为临床选择恰当的治疗方式提供依据。方法:选择2002-01/2009-01在石河子大学医学院第一附属医院骨一科治疗的230例髌骨骨折患者,其中143例应用改良克氏针张力带内固定治疗,87例应用髌骨爪置入内固定治疗。从手术时间、骨折愈合时间、并发症发生率、治疗费用和关节功能评价4个方面进行比较。结果与结论:两组病例均获随访4个月以上。①对于单纯横行骨折,两组病例在手术时间、骨折愈合时间、置入后疗效、置入后并发症发生率差异均无显著性意义(P>0.05),髌骨爪组的治疗费用明显高于张力带组(P<0.01)。②在粉碎性骨折的治疗中,手术时间和骨折愈合时间差异不明显(P>0.05),髌骨爪组的治疗费用明显高于张力带组(P<0.01),髌骨爪组置入后并发症发生率显著低于张力带组(P<0.01),髌骨爪内固定组优良率为100%,显著高于改良克氏针张力带内固定组78.9%(P<0.01)。③应用改良张力带治疗单纯横行骨折疗效可靠,明显减低医疗消耗,可作为髌骨横行骨折首选治疗方法。对于复杂粉碎性骨折,髌骨爪具有固定可靠、疗效显著的优点,应受到临床医生的重视。BACKGROUND：Although there are many internal fixation materials for clinical treatment of patellar fractures.It requires investigation how to select appropriate medical condition,treatment with precise effect and feasible materials.OBJECTIVE：To compare the therapeutic effect of modified tension-band wire and memory alloy patellar holder on patellar fractures to provide evidence for choosing appropriate treatment method in clinic.METHODS：A total of 230 patients with patellar fracture,treated in First Department of Orthopedics,First Affiliated Hospital of Shihezi University between January 2002 and January 2009 were retrospectively reviewed.Of them,143 were treated with modified tension-band wire,and 87 with memory alloy patellar holder.The operation time,union of fracture time,incidence of complications,total cost of hospitalization and functional outcome was assessed with Bostman score system were compared.RESULTS AND CONCLUSION：Al1 the patients were followed up for more than 4 months.There was no statistically significant among the two groups in every index（P 0.05）.But memory alloy patellar holder was more costly compared with modified tension-band wire（P 0.01）.In therapy for comminuted fracture,the operation time and healing time was similar in two groups（P 0.05）,The incidence of complications in memory alloy patellar holder group was significantly lower compared with modified tension-band wire（P 0.01）,and the excellent and good rate of memory alloy patellar holder group was 100%,significantly greater than modified tension-band wire group（P 0.01）.K-wire tension band internal fixation should be the routine method in treating the patellar transverse fracture for the advantage of reliable effect,low cost and easy to spread.Memory alloy patellar holder has the advantage of reliable fixation,less surgical trauma and fewer complications.

关 键 词：髌骨骨折 内固定 改良克氏针张力带 髌骨爪 疗效 

分 类 号：R318[医药卫生—生物医学工程]