关节镜下闭合复位加压螺钉内固定治疗髌骨横断骨折的效果  

Effect of closed reduction and compression screw internal fixation under arthroscopy in treatment of patellar transverse fracture

作　　者：靳宇[1] 孙虹斐 刘小刚[3] 刘志权[1] 史福东[2] 

机构地区：[1]河北省唐山市人民医院急诊科,河北唐山063001 [2]河北省唐山市人民医院骨科,河北唐山063001 [3]河北省唐山市第二医院急诊科,河北唐山063000

出　　处：《中国医药导报》2017年第12期85-88,共4页China Medical Herald

摘　　要：目的探讨关节镜下闭合复位加压螺钉内固定治疗髌骨横断骨折的临床效果。方法选取唐山市人民医院2011年12月~2015年12月诊治的髌骨横断骨折患者38例,根据治疗方案分为两组,对照组患者21例实施切开复位克氏针钢丝张力带内固定术治疗,观察组患者17例实施关节镜下闭合复位加压螺钉内固定术治疗。于治疗前后给予患者Lysholm评分,并行膝关节活动度检测,比较两组患者手术指征、临床疗效、并发症。结果治疗后,观察组患者膝关节活动度[(138.9±7.1)°]、Lysholm评分[(93.2±2.6)分]、治疗优良率(100.0%)均高于对照组[(126.4±5.2)°、(84.7±3.1)分、76.2%],差异有统计学意义(P<0.05)。观察组患者手术时间[(61.2±4.5)min]、术中出血量[(27.0±3.8)mL]、术后住院时间[(7.6±0.7)d]均少于对照组[(82.7±11.4)min、(98.6±10.3)mL、(11.2±1.3)d],差异有统计学意义(P<0.05)。观察组患者骨折愈合时间[(10.1±0.9)周]早于对照组[(18.3±1.5)周],差异有统计学意义(P<0.05)。观察组患者并发症发生率(5.9%)低于对照组(38.1%),差异有统计学意义(P<0.05)。结论关节镜下闭合复位加压螺钉内固定治疗髌骨横断骨折的疗效显著,且安全性高,值得临床推广使用。Objective To investigate clinical effect of closed reduction and compression screw internal fixation under arthroscopy in treatment of patellar transverse fracture. Methods From December 2011 to December 2015, in Tangshan People＇s Hospital, 38 patients with patellar transverse fracture were selected divided into two groups according to treatment plan. 21 patients received open reduction and wire tension band internal fixation was as control group, 17 patients received closed reduction and compression screw internal fixation was as observation group. Lysholm score evaluated before and after treatment, while knee joint mobility detected. Surgical indications, clinical efficacy, complications were compared between two groups. Results After treatment, knee joint mobility [（138.9±7.1）°], Lysholm score [（93.2±2.6） points], excellent treatment rate （100.0%） in observation group were higher than those in control group [（126.4±5.2）°, （84.7±3.1） points, 76.2%], the differences were statistically significant （P 〈 0.05）. Operation time [（61.2±4.5） min], intraoperative blood loss [（27.0±3.8） mL], postoperative hospitalization time [（7.6±0.7） d] in observation group were less than control group [（82.7±11.4） min, （98.6±10.3） mL,（11.2±1.3） d], the differences were statistically significant （P 〈 0.05）. Fracture healing time [（10.1±0.9） weeks] in observation group was earlier than that in control group [（18.3±1.5） weeks], the difference was statistically significant （P 〈 0.05）. Complication rate （5.9%） in observation group was lower than that in control group （38.1%）, the difference was statistically significant （P 〈 0.05）. Conclusion Closed reduction and compression screw internal fixation under arthroscopy has significant effect in treatment of patellar transverse fracture, it has high safety and worth of clinical application.

关 键 词：关节镜 加压螺钉 克氏针 并发症 髌骨横断骨折 

分 类 号：R687.3[医药卫生—骨科学]