针缆系统多轴固定治疗粉碎性髌骨骨折8例  

Application of 8 cases of multi-axis fixation with wire and cable system in comminuted patellar fracture

作　　者：王凌志[1] 潘宏[1] 方帆 吴一凡 WANG Lingzhi;PAN Hong;FANG Fan;WU Yifan(Department of Orthopaedics,Anqing Municipal Hospital,Anqing,Anhui 246000,China)

机构地区：[1]安庆市立医院骨科,安徽安庆246000

出　　处：《安徽医药》2020年第8期1603-1606,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的比较针缆系统多轴固定及传统张力带治疗髌骨粉碎性骨折的疗效。方法选取2017年2月至2018年5月在安庆市立医院进行治疗的单侧复杂粉碎性髌骨骨折病人21例,依据手术方案分为针缆系统多轴固定组(观察组)8例和克氏针张力带组(对照组)13例。比较两组术中出血量、手术时间、住院花费、术后并发症、膝关节功能等。结果观察组与对照组手术时间[(47.50±8.86)min比(51.54±5.91)min]、术中出血量[(66.25±25.60)m L比(69.23±13.82)m L]差异无统计学意义(P>0.05)。住院费用对照组(1.12±0.11)万元,观察组(1.53±0.28)万元,对照组少于观察组。观察组6个月后膝关节功能Bostman评分(26.50±2.93)分优于对照组(22.69±3.35)分,差异有统计学意义(P<0.05)。观察组皮肤激惹2例,未发现针缆断裂、髌骨针脱出、骨折移位等现象,对照组皮肤激惹3例,骨折轻度移位2例,观察组优于对照组。结论针缆系统多轴固定方式具有操作简便、并发症少、效果良好的特点,在治疗粉碎性髌骨骨折上是值得推荐的手术方案。Objective To investigate the effect of multi-axis fixation with wire and cable system and Kirschner wire tension band in the treatment of comminuted patellar fracture.Methods Twenty-one patients with comminuted patellar fracture treated in Anqing Municipal Hospital from February 2017 to May 2018 were retrospectively analyzed,and assigned into 8 patients of multi-axis fixation of the wire and cable system(observation group)and 13 patients of tension band fixation of the Kirschner wire(control group)according to the surgical plan.The amount of bleeding during the operation,the operation time,hospital expenses,postoperative complications and knee function were compared and analyzed.Results There was no significant difference in operation time[(47.50±8.86)min vs.(51.54±5.91)min]and bleeding volume[(66.25±25.60)mL vs.(69.23±13.82)m L]between the two groups(P>0.05).The cost of hospitalization in the control group(1.12±0.11)was significantly less than that in the observation group(1.53±0.28).The Bostman score(26.50±2.93)of the knee function in the observation group was better than that in the control group(22.69±3.35)after 6 months,and the difference was statistically significant(P<0.05).There were 2 cases of skin irritation in the observation group,and no phenomena such as broken needle cables,patellar needle prolapse,and fracture displacement were found.In the control group,3 cases of skin irritation and 2 cases of mild fracture displacement were observed.The observation group was superior to the control group.Conclusion The multi-axis fixation with wire and cable system has the characteristics of simple operation,less complications and good results.It is recommended to treat comminuted patellar fracture.

关 键 词：膝损伤 髌骨 骨折固定术 内 髌骨骨折 针缆系统 多轴固定 

分 类 号：R687.3[医药卫生—骨科学]