改良张力带钢丝内固定治疗髌骨骨折的效果分析  

Therapeutic Effect of Improved Tension Band Internal Fixation for the Treatment of Patella Fracture

作　　者：王建雄 李永宁 张晨 马志伟 陈德胜[3] WANG Jianxiong;LI Yongning;ZHANG Chen;MA Zhiwei;CHEN Desheng(The Third People's Hospital of Yinchuan,Yinchuan 750001,China;The Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China;General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]银川市第三人民医院,银川750001 [2]宁夏医科大学临床医学院,银川750004 [3]宁夏医科大学总医院,银川750004

出　　处：《宁夏医科大学学报》2020年第8期824-827,共4页Journal of Ningxia Medical University

基　　金：宁夏自然科学基金重点项目(2018AAC02013);宁夏医科大学校级课题重点项目(XZ2018014)。

摘　　要：目的观察改良张力带钢丝内固定与拉力螺钉内固定治疗髌骨骨折的疗效差异。方法回顾性分析2015年9月—2018年9月银川市第三人民医院收治的94例髌骨骨折患者,根据手术方法分为观察组(采用改良张力带钢丝内固定治疗,56例),对照组(采用拉力螺钉内固定治疗,38例)。观察两组患者术后视觉模拟疼痛评分(VAS)、膝关节美国特种外科医院评分(HSS)以及术后内固定和并发症发生情况,评定改良张力带钢丝内固定治疗髌骨骨折的临床疗效。结果观察组患者术后骨性愈合时间低于对照组;观察组患者术后内固定取出率高于对照组;观察组患者术后1周、1个月膝关节HSS均高于对照组;观察组髌骨相关再次手术率高于对照组(P均<0.05);两组患者术后感染率差异无统计学意义(P>0.05)。结论对于复杂的髌骨骨折,可采用改良张力带固定技术,效果较好。Objective To analyze the difference of therapeutic effect between modified tension band internal fixation and screw internal fixation for the treatment of patella fracture and analyze its biofixation mechanics and its influencing factors. Methods A retrospective analysis of 56 patients with patella fractures treated with modified tension band wire internal fixation and 38 patients with patella fractures treated with screw internal fixation was performed from September 2015 to September 2018. The internal fixation failure rate,internal fixation removal rate,postoperative VAS score,knee HSS score and complication related to patella fracture were used as indicators to evaluate the clinical efficacy of modified tension band wire fixation for patella fracture and to analyze its biomechanics and influence its biomechanical factors. Results The postoperative bone healing time of the observation group was lower than that of the control group;the removal rate of internal fixation in the observation group was higher than that of the control group;the HSS of the knee joint of the observation group was higher than that of the control group at 1 week and 1 month after operation;The patella-related reoperation rate was higher than that of the control group(P all<0.05);there was no significant difference in postoperative infection rate between the two groups(P>0.05). Conclusion Modified tension band internal fixation for the treatment of patella fractures has a wide range of indications and good clinical results,and it is more suitable for complex comminuted fractures.

关 键 词：改良张力带钢丝内固定 拉力螺钉内固定 髌骨骨折 术后康复 

分 类 号：R687.3[医药卫生—骨科学]