缝线与髌骨针钛缆张力带固定治疗粉碎性髌骨骨折的优、缺点比较  

Comparison of the advantages and disadvantages of suture and patellar needle and titanium cable tension band fixation in the treatment of comminuted patellar fractures

作　　者：董文林 陈岩 陈焕庆 叶克勇 温喜乐 李阳明 DONG Wen-lin;CHEN Yan;CHEN Huan-qing;YE Ke-yong;WEN Xi-le;LI Yang-ming(Dept of Orthopaedics,the People′s Hospital of Pingyang County,Wenzhou,Zhejiang 325400,China)

机构地区：[1]平阳县人民医院骨科,浙江温州325400

出　　处：《临床骨科杂志》2023年第1期103-106,共4页Journal of Clinical Orthopaedics

基　　金：浙江省温州市科技局基础性科研项目(编号:Y20220723)。

摘　　要：目的比较缝线缝合法配合石膏外固定和髌骨针钛缆张力带固定治疗粉碎性髌骨骨折的优、缺点。方法将80例粉碎性髌骨骨折患者根据固定方式不同分为A组(采用5号爱惜康2次环扎+8字张力带固定+石膏外固定,40例)和B组(采用髌骨针钛缆张力带内固定,40例)。记录两组手术情况、骨折复位及愈合情况、膝关节活动度、术后并发症发生情况。按照Bostman髌骨骨折疗效标准评定膝关节功能。结果患者均获得随访,时间12~24个月。手术时间、住院天数、住院费用A组均短(少)于B组(P<0.05)。术后3个月两组骨折均愈合。术后12个月采用Bostman髌骨骨折疗效标准评定膝关节功能:优良率A组为38/40(95.0%),B组为39/40(97.5%),差异无统计学意义(P>0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论粉碎性髌骨骨折的治疗中,缝线缝合法配合石膏外固定的优点是手术时间短、费用低、二期无需去除内固定,缺点是石膏固定时间长、康复时间长;髌骨针钛缆张力带固定的优点是术后患者可以早期功能锻炼、石膏固定时间短或无需石膏固定,缺点是手术时间长、费用高、需二期取出内固定。Objective To compare the advantages and disadvantages of suture combined with plaster external fixation and patellar needle titanium cable tension band fixation in the treatment of comminuted patellar fracture.Methods According to the different fixation methods,80 patients with comminuted patellar fracture were divided into group A(using No.5 Ethicon twice cerclage plus 8-shaped tension band fixation and plaster external fixation,40 cases)and group B(using patellar needle titanium cable tension band internal fixation,40 cases).The operation situation,fracture reduction and healing,knee joint range of motion,and postoperative complications were recorded.Knee joint function was evaluated according to Bostman criteria for patellar fracture.Results All patients were followed up for 12~24 months.The operation time,hospitalization days and hospitalization cost in group A were all shorter(less)than those in group B(P<0.05).The fractures healed in both groups at 3 months after operation.At 12 months after operation,Bostman patellar fracture criteria were used to evaluate the knee joint function.The excellent-good rate was 38/40(95.0%)in group A,and 39/40(97.5%)in group B,and the difference was not statistically significant(P>0.05).There was no significant difference in the incidence rate of postoperative complications between the two groups(P>0.05).Conclusions In the treatment of comminuted patellar fracture,the advantages of suture combined with plaster external fixation are short operation time,low cost and no removal of internal fixation in the second stage,while the disadvantages are long plaster fixation time and long rehabilitation training time in the later stage.The advantages of patellar needle tension band internal fixation are early functional exercise,short plaster fixation time or no need of plaster fixation,while the disadvantages are long operation time,high cost and the need for secondary removal and internal fixation.

关 键 词：髌骨骨折 缝线 钛针 钛缆 骨折固定术 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]