闭合复位经皮髌骨针张力带微创治疗髌骨骨折  

Minimally invasive treatment of closed reduction and tension-band fixation with percutaneous patellar pin for patellar fractures

作　　者：王湘江[1] 王贵清[1] 万彬[1] 谭小波[1] 张廷帅[1] 

机构地区：[1]清远市人民医院,广州医科大学第六附属医院骨科,广东511518

出　　处：《中国骨科临床与基础研究杂志》2016年第1期15-19,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的 探讨闭合复位经皮髌骨针张力带微创治疗髌骨骨折的临床效果。方法 回顾性分析2010年1月至2014年8月清远市人民医院收治的42例髌骨闭合性横行新鲜骨折（Rockwood分型为Ⅱ型）患者的临床资料,均采用闭合复位、经皮髌骨针结合张力带内固定治疗。记录手术时间、切口长度、术中出血量、住院时间;观察骨折愈合和并发症发生情况;采用Bostman髌骨骨折功能评分标准进行疗效评估。结果 手术时间30~65 min（平均40.6 min）,切口长度1.8~3.2 cm（平均2.4 cm）,术中出血量20~40 m L（平均26.4 m L）,住院时间5~9 d（平均6.5 d）。术后随访12~18个月（平均15.5个月）,骨折愈合时间2~5个月（平均3.8个月）,骨折愈合率100%;术后1年Bostman髌骨骨折功能评分标准：优28例、良14例,优良率100%（42/42）。随访期间无膝关节疼痛不适、骨折再移位及针道感染,无髌骨针旋转、松动及脱出。结论 闭合复位经皮髌骨针张力带治疗髌骨骨折创伤小,固定牢靠,恢复快,疗效满意。Objective To explore the curative effects of close reduction and tension-band fixation withpercutaneous patellar pin for patellar fractures. Methods Clinical data of 42 patients with transverse patellarclosed fractures （Rockwood Ⅱ type） treated by close reduction and tension-band fixation with percutaneouspatellar pin from January 2010 to August 2014 in Qingyuan People＇s Hospital, were analyzed retrospectively. Theoperation time, incision length, intraoperative estimate blood loss, hospitalization stay were recorded, fracturehealing and complications were observed, therapeutic effects were assessed according to Bostman＇s patellafractures functional criteria. Results The operation time ranged from 30 to 65 min （average 40.6 min）, length ofincision was 1.8 to 3.2 cm （average 2.4 cm）, intraoperative estimate blood loss was 20 to 40 mL （average 26.4mL）, length of hospital stay was 5 to 9 days （average 6.5 days）. All patients were followed up for 12 to 18months （average 15.5 months）. The healing duration was 2 to 5 months （average 3.8 months） with fracturehealing rate of 100% . According to Bostman＇s criteria, there was excellent in 28 cases, good in 14, with theexcellent and good rate of 100% （42/42）. There were no complications such as knee joint pain, refracture, pintract infection, or pin rotation, loosening or pull-out during the follow-up period. Conclusions Treatment of closereduction and tension-band fixation with percutaneous patellar pin for patellar fracture is characterized byminimal damage, reliable fixation, early rehabilitation and good functional recovery.

关 键 词：髌骨 骨折 骨折固定术 内 骨固定钢丝 外科手术 微创性 

分 类 号：R687.3[医药卫生—骨科学]