跟骨锁定钢板与克氏针张力带治疗髌骨骨折的病例对照研究  

Case control study on calcaneal locking plates and tension band with Kirschner's nail for the treatment of patellar fracture

作　　者：江开明[1] 钱军 罗志军[1] 陈庆军[1] JIANG Kai-ming;QIAN Jun;LUO Zhi-jun;CHEN Qing-jun(Department of Orthopaedics,Zhejiang Quhua Hospital,Quzhou 324004,Zhejiang,China)

机构地区：[1]浙江衢化医院骨科,浙江衢州324004 [2]横店文荣医院,浙江横店322118

出　　处：《中国骨伤》2018年第10期889-893,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:比较跟骨锁定钢板与克氏针张力带固定治疗髌骨骨折的临床疗效。方法:2009年12月至2017年12月收治髌骨骨折患者58例,按照手术方式不同,分为跟骨锁定钢板内固定组(钢板组)和克氏针张力带固定组(张力带组)。钢板组29例,男14例,女15例,年龄18～72 (36.9±11.5)岁;张力带组29例,男17例,女12例,年龄20～70 (37.7±14.4)岁。观察两组患者的手术时间、术中出血量、骨折愈合时间、随访时间及并发症率,并于术后12个月采用B觟stman评分评价比较术后临床疗效。结果:钢板组随访时间(18.4±2.6)个月,张力带组随访时间(17.8±3.6)个月,两组比较差异无统计学意义(t=2.045,P=0.546);术后12个月B觟stman评分,钢板组(28.5±4.6)分,张力带组(25.7±4.3)分,两组B觟stman评分比较差异有统计学意义(t=2.395,P=0.020);钢板组优26例,良3例;张力带组优14例,良11例,差4例,两组比较差异有统计学意义(χ~2=12.17 P=0.02)。两组患者手术时间(t=1.978,P=0.53)、术中出血量(t=1.740,P=0.87)、骨折愈合时间(t=0.65,P=0.517)及并发症(χ~2=0.268,P=0.604)比较差异无统计学意义。结论:跟骨锁定钢板治疗髌骨骨折具有适用更广,固定更牢靠等优点,临床疗效优于克氏针张力带。Objective：To compare clinical effect between calcaneal locking plates and tension band with Kirschner ＇s nail for the treatment of patellar fracture. Methods：From December 2009 to December 2017,58 patients with patellar fracture were divided into plate group（calcaneal locking plate） and tension band（tension band with Kirschner＇s nail） by surgical method.There were 29 patients in plate group,including 14 males and 15 females,aged from 18 to 72 years old with an average of（36.9±11.5） years old;while there were 29 patients in tension band group,including 17 males and 12 females,aged from 20 to70 years old with an average of（37.7±14.4） years old. Operative time,blood loss,fracture healing time,follow up time and postoperative complications were compared between two groups. Bostman score was applied to compared therapeutic effects at12 months after operation. Results：There was no significant differences in following-up time between plate group（18.4±2.6）months and tension band group（17.8±3.6） months. According to Bostman score at 12 months after operation,plate group was（28.5 ±4.6） and（25.7 ±4.3） in tension band group,and had statistical difference between two group（t =2.395,P =0.020）.Twenty six patients got excellent results,3 moderate in plate group; while 14 patients got excellent results,11 moderate and 4 poor in tension band group,and had obviously meaning between two groups（χ~2=12.17 P=0.02）. There were no significant differences in operative time（t=1.978,P=0.53）,blood loss（t=1.740,P=0.87）,fracture healing time（t=0.65,P=0.517）and postoperative complications（χ~2=0.268,P=0.604） between two groups. Conclusion：Calcaneal locking plates for patellar fracture has advantages of more wide range of clinical application,more reliable fixation,and more satisfactory surgical curative method,its clinical effects is better than that of tension band with kirschner nail.

关 键 词：髌骨 骨折 骨折固定术 

分 类 号：R687.3[医药卫生—骨科学]