经皮与切开复位钢丝环扎加“8”字张力带内固定治疗髌骨骨折的病例对照研究  

Case-control study on the treatment of patellar fracture with "8" tension band wire fixation either by percutaneous or open reduction

作　　者：竺湘江 赵勇[1] 宋南炎 范湧[1] 李建波[1] 

机构地区：[1]嵊州市人民医院骨科,浙江绍兴312400

出　　处：《中国骨伤》2013年第6期449-452,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:比较经皮钢丝环扎加张力带与切开复位钢丝环扎加张力带治疗髌骨骨折的疗效。方法:自2007年7月至2010年4月收治髌骨骨折96例,其中48例采用经皮钢丝环扎加张力带固定术治疗(经皮组),男28例,女20例;年龄21～84岁,平均(53.8±4.7)岁;横行骨折27例,粉碎性骨折21例。48例采用传统切开复位、钢丝环扎及"8"字张力带固定治疗(开放组),男26例,女22例;年龄19～86岁,平均(49.1±4.2)岁;横行骨折25例,粉碎性骨折23例。比较两组手术时间、住院天数、术后第1天及术后1周疼痛评分,并比较两组术后膝关节Bstman评分。结果:所有患者术后获得随访,时间6～19个月,平均13个月。两组手术时间差异无统计学意义。经皮组与开放组比较,经皮组患者住院时间短,骨折愈合时间及术后第1天及术后1周VAS疼痛评分均低于开放组患者。两组患者术后进行Bstman评分,经皮组平均28.8±4.7,开放组平均24.6±4.3,经皮组高于开放组。结论:经皮内固定术治疗髌骨骨折具有创伤小、恢复快等优点,临床疗效优于切开复位内固定术。Objective：To study the clinical efficacy of the treatment of patellar fracture percutaneous or open reduction with ＂8＂ tension band wire fixation. Methods：From July 2007 to April 2010,96 patients with patellar fracture were treated by percutaneous or open reduction with ＂8＂tension band wire fixation. In percutaneous group,there were 28 males and 20 females with an average age of（53.8±4.7） years old（ranged,21 to 84）;there were 27 transverse fractures and 21 comminuted fractures. In open reduction group,there were 26 males and 22 females with an average age of （49.1±4.2） years old （ranged,19 to 86）; there were 25 transverse fractures and 23 comminuted fractures. The operation time,hospital stay,and pain score on the first day and one week after operation were compared,and Bstman score was compared too. Results：All patients were followed up with an average of 13 months ranging from 6 to 19 months. The mean operation time of percutaneous group was （53.0±4.3）min and the open reduction group was（49.0±3.1）min,and there was no statistic differences between two groups（P0.05）. The hospital stay,healing time in percutaneous group was shorter than that of open reduction group ;VAS score on first day and the first week after operation in percutaneous group was lower than that of open reduction group. The mean Bstman score in percutaneous group （28.8±4.7） was lower than open reduction group （24.6±4.3）. Conclusion：Percutaneous internal fixation for the treatment of patellar fracture has advantages of minimally invasive,quick recovery. The clinical effectiveness of this method is superior to the open reduction.

关 键 词：髌骨 骨折 骨折固定术 内 病例对照研究 

分 类 号：R318.01[医药卫生—生物医学工程]