双排锚钉内固定治疗髌骨下极骨折8例:初始固定可靠  

Double-rows technique with suture anchors in eight patients with fracture of distal patellar pole:reliable initial fixation

作　　者：陈羽 俞仲翔[1] 匡勇[1] 王树强[1] 蔡雨卫 房雷[1] 徐盛明 Chen Yu;Yu Zhongxiang;Kuang Yong;Wang Shuqiang;Cai Yuwei;Fang Lei;Xu Shengming(First Department of Orthopedic Surgery,Shuguang Hospital Affiliated to Shanghai University of Chinese Traditional Medicine,Shanghai 200120,China)

机构地区：[1]上海中医药大学附属曙光医院骨一科,上海市200120

出　　处：《中国组织工程研究》2021年第33期5341-5344,共4页Chinese Journal of Tissue Engineering Research

基　　金：上海市科委2020年度“科技创新行动计划”生物医药领域科技支撑项目(20S31901600),项目负责人:陈羽。

摘　　要：背景:髌骨下极骨折是一种特殊类型的髌骨骨折,由于髌骨下极往往是粉碎性骨折,不能提供足够的把持力,因此髌骨骨折常用的技术并不适用,目前也没有治疗髌骨下极骨折手术方法的金标准。目的:探讨双排锚钉技术在髌骨下骨折治疗中的临床疗效。方法:回顾性分析2017年5月至2019年5月在上海中医药大学附属曙光医院使用双排锚钉固定治疗髌骨下极骨折8例患者的病历资料,所有患者均开展系统膝关节功能锻炼,定期随访并进行关节功能评定;对比患者健侧和术后的关节活动度。结果与结论:①8例患者均获得随访,随访时间16-28个月,平均19.5个月;②所有患者切口均Ⅰ期愈合,无感染、锚钉松动、膝前痛等并发症发生,所有骨折均在术后3个月复查时骨性愈合;③术后12个月Bostman髌骨骨折功能评分(28.5±1.5)分,膝关节损伤及骨关节炎疗效评分(93.6±4.4)分,优良率为100%;④术后3个月起(3,6,12个月)患侧膝关节主动屈曲角度均与健侧相比差异无显著性意义(P>0.05);⑤说明双排锚钉技术可以为髌骨下极骨折提供很好的初始固定强度,具有复位效果好、固定可靠、无需二次手术取出内固定、对软组织干扰少和可早期功能锻炼等优点。BACKGROUND:Fracture of distal patellar pole is a special type of patellar fracture.Because of the comminuted inferior pole of patella without enough holding force,the commonly used techniques of patellar fracture are not applicable.There is no gold standard surgical treatment for fracture of distal patellar pole.OBJECTIVE:To investigate the clinical effects of the double-rows technique with suture anchors in fixation of fracture of distal patellar pole.METHODS:A retrospective study was conducted in eight patients with fracture of distal patellar pole in Shuguang Hospital Affiliated to Shanghai University of Chinese Traditional Medicine who underwent double-rows technique with suture anchors from May 2017 to May 2019.Systematic knee joint function exercise was performed in all patients,and joint function evaluation was regularly followed up.The range of motion was compared between the healthy side and postoperative joint.RESULTS AND CONCLUSION:(1)All eight patients were followed up for 16-28 months,with an average of 19.5 months.(2)The incisions of all patients healed in stage I,without complications such as infection,loosening of anchor or pain of knee.Three months later,X-ray films showed bone healing in all patients.(3)At 12 months after operation,Bostman patellar fracture function score was(28.5±1.5);the knee joint injury and osteoarthritis curative effect score was(93.6±4.4);the excellent and good rate was 100%.(4)From 3 months after operation(3,6,12 months),the active flexion angle of the affected side was not significantly different from that of the healthy side(P>0.05).(5)It is concluded that the double-rows technique with suture anchors can provide good initial fixation strength for the fracture of distal patellar pole.It has the advantages of good reduction effect,reliable fixation,no need for secondary surgery to remove internal fixation,less interference to soft tissue and early functional exercise.

关 键 词：髌骨 髌韧带 带线锚钉 髌骨下极骨折 内固定 双排技术 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]