X形锁定接骨板加缝线环扎固定治疗横行髌骨骨折  

X-shaped locking plate combined with suture cerclage for treatment of transverse patellar fractures

作　　者：蒙德鹏[1] 欧阳跃平[1] 陈寅生[1] 赵建国[1] 陈汇浩[1] 王竹[1] 侯春林[1] 

机构地区：[1]第二军医大学附属长征医院骨科,上海200003

出　　处：《中国矫形外科杂志》2017年第10期884-887,共4页Orthopedic Journal of China

摘　　要：[目的]探讨X形四孔锁定板加胸骨缝线环扎治疗髌骨骨折的手术适应证及疗效。[方法]通过回顾性研究,观察低切迹、带变向螺钉的X形多功能接骨钢板加缝线环扎术治疗横行髌骨骨折患者共22例的疗效。对所有患者的功能恢复、并发症和影像学表现进行随访。[结果]平均手术时间,透视次数,术后12个月随访时关节活动和Lysholm评分分别为(47.4±7.7)min,(1.41±0.6)次,(136.44±11.01)°和(92.33±2.79)分,平均VAS评分为(0.42±0.57)分。1例发生关节僵硬,2例发生局部异物刺激反应,并发症发生率为13.6%。所有的患者均获得骨性愈合,无螺钉松动、深静脉血栓及血管神经损伤等重大并发症。[结论]对于髌骨横行关节内骨折,可使用X形锁定板加缝线环扎固定,操作简单,固定效果确切,关节活动度和功能恢复满意,为简单髌骨骨折提供了新的治疗方法。[Objective] To investigate the surgical indications and clinical outcomes of X-shaped four-hole locking plate combined with sternal suture cerclage for treatment of transverse patellar fractures. [Methods] A retrospective analysis was performed in 22 patients with transverse patellar fractures who underwent internal fixation by an X-shaped low-profile plate with variable-angle locking screws, combined with suture cerclage. All the patients were followed up and evaluated in terms of functional recovery, complications, and imaging findings. [Results] The patients had operation lasted for a mean of （47.4±6.8） min, with a mean of （1.41±0.6） times of intraoperative fluoroscopy. No severe complications, such as neurovas- cular injuries and deep vein thrombosis, occurred in any patient. At 12 months after operation, all patients got solid bone healing without implant loosening, and satisfactory outcomes in terms of range of motion （136.4±11.0）°, Lysholm score （92.3±2.8）, and VAS （0.42±0.57） . Of them, 1 patient was complicated with ankylosis of the affected joint and 2 patients experienced local foreign body reaction, which accounted for 13.6% of the 22 patients. [Conclusions] Internal fixation by X-shaped locking plate combined with suture cerclage is simple and reliable treatment for transverse patellar fractures.

关 键 词：横行髌骨骨折 低切迹 手术适应证 多轴锁定板 并发症 

分 类 号：R687.3[医药卫生—骨科学]