空心螺钉缝线固定治疗髌骨横形骨折的疗效分析  

Cannulated screws with sutures for treatment of transverse patellar fractures

作　　者：郭浩 张军 汤俊君 左兆霞 陈仕敏 李双成[1,2] 王博[2] 胡星星[2] 窦美静 陈华[2,4] 唐佩福 Guo Hao;Zhang Jun;Tang Junjun;Zuo Zhaoxia;Chen Shimin;Li Shuangcheng;Wang Bo;Hu Xingxing;Dou Meijing;Chen Hua;Tang Peifu(Graduate School,Chinese PLA General Hospital,Bejing 100853,China;Senior Department of Orthopedics,The Fourth Medical Center of Chinese PLA General Hospital,Beijing 100048,China;The Second Surgical Department,Beijing Municipal Corps Hospital of Chinese People's Armed Police Force,Bejing 100027,China;National Clinical Research Centerfor Orthopaedics,Sports Medicine and Rehabilitation,Beijing 100853,China)

机构地区：[1]解放军总医院研究生院,北京100853 [2]解放军总医院第四医学中心骨科医学部,北京100048 [3]武警北京市总队医院外二科,北京100027 [4]国家骨科与运动康复临床研究中心,北京100853

出　　处：《中华创伤骨科杂志》2022年第12期1055-1062,共8页Chinese Journal of Orthopaedic Trauma

基　　金：院企合作横向课题-骨科类器械临床前相关研究(YQCH201601);首都临床特色应用研究(Z181100001718020)。

摘　　要：目的探讨空心螺钉缝线固定治疗髌骨横形骨折的临床疗效。方法回顾性分析2017年1月至2021年3月期间解放军总医院第四医学中心骨科医学部收治的70例髌骨横形骨折患者资料。根据张力带构建方式不同分为3组:A组21例, 男8例, 女13例;中位年龄为55.0(48.0, 65.0)岁;采用空心螺钉缝线(Fiber Tape)固定治疗。B组32例, 男15例, 女17例;中位年龄为52.5(41.5, 63.0)岁;采用克氏针张力带固定治疗。C组17例, 男5例, 女12例;中位年龄为55.0(37.0, 65.0)岁;采用Cable Pin系统固定治疗。比较3组患者的手术时间、术中出血量、并发症、二次手术(取出内固定物)率及末次随访时膝关节Lysholm评分、B?stman评分等。结果 3组患者术前一般资料的比较差异均无统计学意义(P > 0.05), 具有可比性。3组患者的手术时间、术中出血量及随访时间比较差异均无统计学意义(P > 0.05)。A组患者的软组织激惹发生率为4.8%(1/21), 二次手术率为4.8%(1/21), 显著低于B组患者[43.8%(14/32)、37.5%(12/32)]、C组患者[41.2%(7/17)、35.3%(6/17)], 差异均有统计学意义(P < 0.05), 而B组与C组患者之间比较差异均无统计学意义(P > 0.05)。末次随访时A组、B组、C组患者的膝关节Lysholm评分分别为84.0(69.0,88.0)、89.0(71.5,95.0)、82.0(63.0,90.0)分, Bostman评分分别为26.0(23.0,28.0)、26.5(24.0,27.5)、26.0(22.0,28.0)分, 差异均无统计学意义(P > 0.05)。3组患者其他并发症发生率的比较差异无统计学意义(P > 0.05)。结论与克氏针张力带、Cable Pin系统相比, 空心螺钉缝线构建张力带结构治疗髌骨横形骨折的软组织激惹发生率和二次手术率更低, 而手术时间、术中出血量、其他并发症发生率及术后功能评分无明显差异。Objective:To evaluate the clinical efficacy of cannulated screws with sutures in the treatment of patellar transverse fractures.Methods:A retrospective analysis was performed of the data of 70 patients with patellar transverse fracture who had been admitted to Senior Department of Orthopedics,The Fourth Medical Center of Chinese PLA General Hospital from January 2017 to March 2021.According to the construction methods for the tension band,the patients were divided into 3 groups.In group A of 21 cases subjected to fixation with cannulated screws with sutures(Fiber-Tape),there were 8 males and 13 females with a median age of 55.0(48.0,65.0)years;in group B of 32 cases subjected to fixation with Kirschner wire tension band,there were 15 males and 17 females with a median age of 52.5(41.5,63.0)years;in group C of 17 cases subjected to fixation with Cable-Pin system,there were 5 males and 12 females with a median age of 55.0(37.0,65.0)years.The 3 groups were compared in terms of complications,secondary surgery(removal of internal fixation),operation time,intraoperative blood loss and knee function rated by the Lysholm and B?stman scores at the last follow-up.Results:There were no significant differences in the preoperative general data between the 3 groups,showing they were comparable(P>0.05).There was no significant difference in the operation time,intraoperative blood transfusion or follow-up time among the 3 groups(P>0.05).The incidence of soft tissue irritation[4.8%(1/21)]and the secondary operation rate[4.8%(1/21)]in group A were significantly lower than those in group B[43.8%(14/32)and 37.5%(12/32)]and group C[41.2%(7/17)and 35.3%(6/17)](P<0.05),but there was no statistically significant difference between group B and group C(P>0.05).In groups A,B and C,respectively,the Lysholm knee score was 84.0(69.0,88.0),89.0(71.5,95.0)and 82.0(63.0,90.0),and the Bostman knee score 26.0(23.0,28.0),26.5(24.0,27.5)and 26.0(22.0,28.0),showing no significant difference(P>0.05).There was no significant difference either in the in

关 键 词：髌骨骨折 骨折固定术 内 骨钉 缝线 克氏针张力带 Cable Pin系统 

分 类 号：R687.3[医药卫生—骨科学]