丝线环扎加张力带钢丝联合固定治疗粉碎性髌骨骨折  

Ring ligation thread combined tension band wire fixation of comminuted patella fracture

作　　者：沈健 殷渠东 

机构地区：[1]江苏省荣军医院,江苏无锡214035 [2]无锡市第九医院

出　　处：《中国民康医学》2010年第24期3119-3119,3229,共2页Medical Journal of Chinese People’s Health

摘　　要：目的：探讨丝线环扎加张力带钢丝联合固定在治疗粉碎性髌骨骨折中应用的可行性及特点。方法：选择丝线环扎加张力带钢丝联合固定治疗的新鲜粉碎性髌骨骨折26例。于髌前做弧形或纵形切口,按皮肤切口切开皮下组织,向两侧略游离皮下组织,暴露骨折端,清除关节内积血和凝血块,尽量保护与骨片相连的髌前腱膜。直视下将骨块复位,用复位钳临时固定,用10号粗丝线在髌骨的上下部分边缘分别作半荷包缝合,术者和助手同时徐徐收紧两侧缝线并结扎固定,然后用直径1.0~1.2mm钢丝紧靠髌骨上下极穿过股四头肌腱及髌韧带后方,两股钢丝由髌前8字交叉兜紧固定,剪去多余部分,末端弯曲埋于软组织内,修补关节囊与支持带扩张部,置负压引流。随诊12~24个月。结果：优良率100%,无骨折再移位。结论：该方法操作简便,创伤小,固定可靠,能早期活动,符合生物力学原理,是治疗粉碎性髌骨骨折的有效方法。Objective：To explore the thread tension with steel combined with fixed in the treatment of patella fracture comminuted and application of the feasibility of this method and characteristics.Methods：Select the thread tension with steel combined with fixed treatment of patella fracture patient comminuted fresh 26 patients.On basis of longitudinal incision arc or previous image,according to the skin incision through subcutaneous tissue,to free subcutaneous tissue,slightly exposure,remove intra-articular fractures and try to protect blood clots,buildup of bone connected with the patellar tendon film before.Looking down bone pieces,with temporary fixation,reset the clamp in 10 thick thread of patella upper part and the edges suture respectively,performer and pouch half assistant and slowly tightening and ligation suture fixation on both sides,then with diameter 1.0 ~ 1.2mm wire abuts patellar tendon and total olume through the patellar tendon and rear two wire by eight word patella fixation,cross pocket tight subtractive redundant,buried soft tissue bending terminal,repairing joint capsule and support,with expansion of negative pressure drainage.Follow-up 12~24 months.Results：Dykes 100%,no bone.Conclusion：The method is simple,reliable,trauma,fixed to early with biomechanics principles;the treatment of patella fracture comminuted is a kind of effective method.

关 键 词：髌骨骨折 张力带 丝线环扎 内固定 

分 类 号：R683.42[医药卫生—骨科学]