钛缆环扎联合8字减张带治疗髌骨下极粉碎性骨折  

Analysis of Circular Band Fixation Combined with 8-shaped Decreasing Tension Band in Treatment of the Comminuted Inferior Polar Fracture of Patella

作　　者：孙海波 周君琳 张万龙 齐明 李华 冯国英 王心宽 

机构地区：[1]北京市通州区中西医结合医院骨科,北京101100 [2]北京市朝阳区朝阳医院创伤骨科,北京100000

出　　处：《实用骨科杂志》2015年第3期217-219,286,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨钛缆环扎联合8字减张带治疗髌骨下极粉碎性骨折的临床疗效分析。方法 2008年8月至2013年8月收治60例髌骨下极粉碎性骨折患者,其中35例（A组）采用钢丝环扎联合8字减张带术式,25例（B组）采用钛缆环扎联合8字减张带术式。术后定期随访,采用术后膝关节活动度（range of motion,ROM）评分、Bostman评分表评定膝关节功能恢复情况。结果 A组35例中28例获得随访,B组25例中23例获得随访,随访时间为12~15个月,平均（13.91±0.56）个月。两组间性别、年龄、骨折愈合率和愈合时间差异无统计学意义（P〉0.05）。末次随访时,患侧膝关节活动度（ROM）：A组（130.35±7.19）°,B组（133.69±7.11）°,两组比较差异无统计学意义（P〉0.05）,Bostman评分：A组平均得分（24.25±3.21）分,优1 5例,良1 0例,差3例,优良率8 9.2 9%;B组平均得分（28.35±2.21）分,优20例,良2例,差1例,优良率95.65%,两组间差异有统计学意义（P〈0.05）。结论钛缆环扎联合8字减张带治疗髌骨下极粉碎性骨折,术后具有并发症少、术后恢复快等优点,有着广泛的应用前景。Objective To investigate the clinical effects of circular band fixation combined with 8-shaped decreasing tension band in treating the comminuted inferior polar fracture of patella. Methods From August 2008 to August 2013,60 patients were diagnosed with comminuted inferior polar fracture of patella. 35 cases of inferior polar fracture of the patella（ group A） were operated as circular band fixation combined with 8-shaped decreasing tension band by wire,and 35 cases were operated by cable. The range of motion（ ROM） and the Bostman knee scores were applied to evaluate function of the knee. Results28 patients of group A and 23 patients of group B were followed up for 12 ~ 15 months,the mean follow-up period was 13. 91 ±0. 56 months. The heal rate and heal time were no statistical significance between two groups（ P〉0. 05）. At the last followup. The range of motion（ ROM） between two groups（ A groups： 130. 35 ± 7. 19,B groups： 130. 35 ± 7. 19） had no statistical significance（ P〉0. 05）. According to the Bostman knee scores,there were 15 excellent cases,10 good cases,3 fair case in group A,the excellent-good rate was 89. 29%,and the scores were 24. 25 ± 3. 21; there were 20 excellent cases,2 good cases,1 fair case in group B,the excellent-good rate was 95. 65%,and the scores were 28. 35 ± 2. 21,and the scores had statistical significance（ P〈0. 05）. Conclusion Circular band fixation combined with 8-shaped decreasing tension band with cable is an effective method to treat the comminuted inferior polar fracture of patella with few complications and favorable recovery.

关 键 词：髌骨下极骨折 8字减张带 钛缆 

分 类 号：R683.42[医药卫生—骨科学]