关节镜辅助闭合复位导向器引导内固定与切开复位治疗髌骨骨折的疗效比较  

Comparison of arthroscopic assisted closed reduction guider guided internal fixation and open reduction for the treatment of tibiofibular fracture

作　　者：王磊[1] 魏增伯 杨建磊[1] 李基新 陈德生[2] 刘有军[1] 边华 龚雪 WANG Lei;WEI Zeng-bo;YANG Jian-lei;LI Ji-xin;CHEN De-sheng;LIU You-jun;BIAN Hua;GONG Xue(Department of Orthopaedics, Tianjin Beichen Hospital, Tianjin 300400, China;Department of Arthroscopy and Sport Medicine, Tianjin Hospital)

机构地区：[1]天津市北辰医院骨科,300400 [2]天津医院关节镜与运动医学科

出　　处：《天津医药》2019年第9期943-947,共5页Tianjin Medical Journal

摘　　要：目的探讨关节镜辅助闭合复位导向器引导内固定治疗髌骨骨折的手术方法,并与经典的切开复位克氏针钢丝张力带内固定术比较,评价其临床疗效。方法选自2016年1月-2018年1月利用自行研制的髌骨闭合复位导向器,完成关节镜辅助髌骨骨折闭合复位空心钉内固定术患者30例(关节镜闭合复位组),另选取2015年3月-2017年5月传统切开复位克氏针钢丝张力带内固定病例30例(切开复位内固定组),比较2组患者手术切口长度、手术时间、术后疼痛评分、骨折愈合时间、Lysholm膝关节评分等,评价其疗效。结果 2组均随访12~18个月,骨折均愈合,愈合率100%。关节镜辅助闭合复位导向器组的手术切口长度、术后疼痛评分、骨折愈合时间、Lysholm膝关节评分指标均优于切开复位组(P<0.05)。结论使用自行研制的闭合复位导向器进行关节镜辅助闭合复位空心钉内固定术,相比较经典的切开复位克氏针钢丝张力带内固定术,具有微创和精准的优势,临床效果良好。Objective To explore the surgical method of arthroscopic-assisted closed reduction and internal fixation guided by guider for patellar fracture, and compare it with classic open reduction Kirschner wire and wire tension band internal fixation to evaluate its clinical efficacy. Methods From January 2016 to January 2018, 30 cases of arthroscopic assisted patellar fracture closed reduction and cannulated screw internal fixation were completed by using a self-developed patellar closed reduction guide apparatus (arthroscopic assisted closed reduction guide group). From March 2015 to May 2017, 30 cases of traditional open reduction Kirschner wire and steel wire tension band internal fixation were selected (open reduction group). The operation incision size, operation time, postoperative pain score, fracture healing time, Lysholm knee joint score and other evaluation results were compared between the two groups. Results Both groups were followed up for 12 to 18 months. All fractures were healed with a healing rate of 100%. The operation incision size, postoperative pain score, fracture healing time and Lysholm knee joint score index were significantly better in arthroscopic assisted closed reduction guide group than those of open reduction group (P<0.05). Conclusion Arthroscopic assisted closed reduction hollow nail internal fixation using the closed reduction guider developed by the author has the advantages of minimal invasion and accuration and has good clinical effect compared with the classic open reduction Kirschner wire and wire tension band internal fixation.

关 键 词：髌骨 骨折 关节镜检查 骨折固定术 内 闭合复位导向器 

分 类 号：R683.42[医药卫生—骨科学]