髌骨粉碎性骨折切开复位和髌骨部分切除的远期疗效比较  

A comparative study on the long-term effects of open reduction internal fixation and partial patellectomy for comminuted patellar fractures

作　　者：李旭[1] 李石伦 韩雪 马新喆 刘建宁[1] 王伟[1] 郭跻超[1] 徐国辉[1] 齐向北[1] LI Xu;LI Shilun;HAN Xue(Department of Osteology,Xiangjiangyuan Branch of The Third Hospital of Hebei Medical University,Hebei,Shijiazhuang 050051,China;不详)

机构地区：[1]河北医科大学第三医院湘江园区骨四科,石家庄市050051 [2]河北医科大学第三医院关节一科 [3]河北省体育科学研究所 [4]河北省石家庄市第三医院

出　　处：《河北医药》2020年第15期2278-2281,2286,共5页Hebei Medical Journal

基　　金：河北省卫生和计划生育委员会青年科技课题(编号:20190651)。

摘　　要：目的比较切开复位内固定术和髌骨部分切除术治疗髌骨粉碎性骨折的远期疗效。方法回顾性分析1980至2003年收治的髌骨粉碎性骨折患者46例,其中采用切开复位内固定术25例,采用髌骨部分切除术治疗21例,每次随访时,拍摄患肢正侧位X线评估患者骨折愈合情况,指导下一步康复计划;随访后期,X线片用于判断患者膝关节炎的进展情况。对患者进行AKS膝关节功能评分、膝关节Bostman评分、膝关节Lysholm评分和视觉模拟评分法(visual analogue scale,VAS),记录并评价患者术后功能和疼痛情况;评估患者股四头肌肌力,测量患者双腿伸直位时髌骨上缘近端10 cm和20 cm处大腿周径,间接反映双侧股四头肌肌力情况。结果46例患者平均随访时间26.5年(14.2~35.9年),末次随访时各项数值差异均无统计学意义(P>0.05)。结论髌骨粉碎性骨折患者行切开复位内固定和髌骨部分切除术,两种术式远期疗效无明显差异。Objective To investigate the long-term effects of open reduction internal fixation and partial patellectomy in treatment of comminuted patellar fractures.Methods A retrospective analysis was performed in 46 patients with comminuted patellar fracture who were admitted and treated in our hospital from 1980 to 2003,of whom,25 patients were treated by open reduction and internal fixation,and the other 21 patients were treated by partial patellectomy.During follow-up,X-rays was taken at AP and lateral views of the affected limb to evaluate the fracture healing status of the patient and guide the next rehabilitation scheme.At the later period of follow-up,X-rays were used to determine the progression status of knee arthritis.The American knee society(AKS)knee function score,Bostman Knee score,Lysholm Knee score and visual analogue scale(VAS)visual analogue scale were used to record and evaluate postoperative function and pain degree of patients.Moreover the peri-thigh diameter at 10cm and 20cmabove the patella was measured,which indirectly reflected the muscle strength of bilateral quadriceps femoris.Results The average follow-up time of the 46 patients was 26.5 years(14.2~35.9 years),and there were no significant differences in the indexes mentioned above at the last follow-up between the two groups(P>0.05).Conclusion There are no significant differences in the long-term curative effects between open reduction internal fixation and partial patellectomy in treatment of comminuted patella fracture.

关 键 词：髌骨骨折 髌骨部分切除术 切开复位内固定 疗效 

分 类 号：R683.42[医药卫生—骨科学]