正骨手法闭合复位经皮骨片钉内固定配合中药熏洗治疗横行髌骨骨折  

Closed reduction by bone setting manipulation and percutaneous fi xation by fragment pin combined with fumigation and washing method for treatment of transverse patellar fractures

作　　者：郑金文[1] 刘显东[1] 朱江伟[1] 陈伟[1] 韩杰[1] 陈星宇[1] 池雷霆[2] 

机构地区：[1]四川省骨科医院,成都610041 [2]成都市第一人民医院,成都610041

出　　处：《中华中医药杂志》2014年第3期958-960,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：2010年四川省中医药管理局科研项目基金(No.2010-57)~~

摘　　要：目的:探讨正骨手法闭合复位经皮骨片钉内固定配合中药熏洗治疗横行髌骨骨折的临床疗效及安全性。方法:38例横行髌骨骨折随机分成治疗组和对照组,治疗组行正骨手法闭合复位经皮骨片钉内固定配合术后软筋化坚洗药熏洗,对照组行切开复位张力带钢丝内固定。结果:治疗组切口长度(2.4±0.5)cm小于对照组(8.9±1.2)cm(P<0.01),在术后第1、2、3、7、14天的视觉疼痛评分(VAS)小于对照组(P<0.01),骨折愈合时间(9.3±2.2)周小于对照组(13.1±2.1)周(P<0.01)。术后6个月治疗组膝关节活动度(140.2±6.8)°与对照组(138.4±6.5)°相当,但Bostman评分(29.5±1.5)高于对照组(27.8±1.7)(P<0.01)。治疗组2例、对照组3例出现内固定刺激症状,治疗组0例、对照组2例出现内固定松动。结论:正骨手法闭合复位经皮骨片钉内固定配合中药熏洗治疗横行髌骨骨折疗效好,安全性高。Objective： To research the clinical efficacy and safety of closed reduction by bone setting manipulation and percutaneous fixation by fragment pin combined with postoperative fumigation and washing method for treatment of transverse patellar fractures. Methods： 38 cases of transverse patellar fracture patients were randomly divided into treatment group and control group. Patients in treatment group were treated with closed reduction by bone setting manipulation and percutaneous fixation by fragment pin, followed two weeks fumigation and washing therapy by Ruanjinhuajian lotion. Patients in control group were treated with open reduction and internal fixation by tension band wire. Results： Average incision length of the treatment group was （2.4±0.5） cm, while （8.9±1.2） cm of the control group （P〈0.01）. At the 1st, 2nd, 3rd, 7th, 14th day postoperatively, the VAS scores in the treatment group were lower than those in the control group （P〈0.01）. The fracture healing time of the treatment group was （9.3±2.2） weeks, lower than （13.1±2.1） weeks of the control group （P〈0.01）. At 6 months postoperatively, the average range of motion of the treatment group was （140.2±6.8） °, compared with （138.4±6.5）° of the control group （P=0.32）. But the Bostman score of the treatment group was an average of （29.5±1.5）, higher than （27.8±1.7） of the control group （P〈0.01）. 2 cases of the treatment group and 3 of the control group had internal fixation irritation. None cases of the treatment group and 2 of the control group occurred internal fixation loosening. Conclusion： The treatment, that closed reduction by bone setting manipulation and percutaneous fixation by fragment pin combined with postoperative fumigation and washing method for treatment of transverse patellar fractures, showed better efficacy and safety.

关 键 词：髌骨 骨折 微创手术 中药熏洗 

分 类 号：R687.3[医药卫生—骨科学]