髌骨环内固定治疗髌骨粉碎性骨折的临床效果分析  

Effectiveness of Patellar Ring Fixation in Treatment of Comminuted Patellar Fracture

作　　者：周志刚[1] 傅江明 李强[1] 严朝华[1] 周欢斌 喻巍[1] 

机构地区：[1]南昌大学附属九江医院,江西九江322000

出　　处：《中国医学创新》2016年第28期27-30,共4页Medical Innovation of China

摘　　要：目的:评估髌骨环内固定治疗髌骨粉碎性骨折的疗效。方法:选取2010年1月-2014年2月于本院接受治疗的58例髌骨粉碎性骨折患者,随机分为髌骨环内固定组与张力带钢丝内固定组,每组各29例。术后对患者进行至少1年的随访,搜集数据主要包括术后骨折愈合时间,疼痛程度,膝关节的活动范围,并且记录Bostman评分及术后并发症。结果:髌骨环内固定组的手术时间为(30.98±12.00)min,明显短于张力带钢丝内固定组的(65.10±14.50)min;术中出血量为(127.30±15.00)mL,明显低于张力带钢丝内固定组的(218.73±20.44)m L,两组比较差异均有统计学意义(P<0.05)。髌骨环内固定组骨折平均愈合时间为术后3个月,无骨折再移位和内固定失效发生,术后膝关节的活动度平均为130°,Bostman平均得达到28分,且治疗效果为优秀的23例(79.3%)明高于张力带钢丝内固定组的15例(51.72%),两组比较差异有统计学意义(P<0.05)。结论:应用髌骨环治疗髌骨粉碎性骨折操作简单,固定灵活,可以获得良好的临床结果,不增加并发症的发生。Objective： To evaluate the effect of a new fixation technique for comminuted patellar fracture using patellar rings. Method： 58 patients with comminuted patella fracture treated in our hospital from January 2010 to February 2014, they were randomly divided into the patellar ring fixation group and the tension band wire fixation group, 29 cases in each group.Patients were followed up for at least 1 year.The data mainly included the time of fracture healing, the degree of pain, the range of motion of the knee joint, and the Bostman score and postoperative complications of two groups were recorded.Result： The operation time of patellar ring in fixation group was （ 30.98 ±12.00 ） mix, significantly shorter than the tension band wire fixation group of（ 65.10 ± 14.50 ） mix; intraoperative blood loss was （ 127.30 ＋ 15.00 ） mL, significantly lower than the group of tension band wire fixation （ 218.73 ± 20.44 ） mL, the differences were statistically significant （ P〈0.05 ） .Patellar ring fixation group average healing time was 3 months after operation, no fracture displacement and failure of the internal fixation, postoperative knee joint activity for an average of 130 degrees, the average Bostman to reach 28 points, the treatment effect good of 23 cases （ 79.3% ）, significantly higher than that in tension band wire the fixed group of 15 cases （51.72%）, there was significant difference between two groups （P〈0.05） .Conclusion： It is a simple, flexible fixation, and a good outcomes by using patellar ring for treating eomminuted patellar fracture and is beneficial for patient to start early functional exercise.

关 键 词：粉碎性髌骨骨折 髌骨环 切开复位内固定 张力带 

分 类 号：R687.32[医药卫生—骨科学]