改良张力带钢丝联合带线锚钉内固定治疗髌骨下极粉碎性骨折的效果  

Effect of modified tension band wire jointed suture anchor internal fixation in the treatment of the inferior patellar comminuted fracture

作　　者：董志军 刘福尧 潘圆 DONG Zhijun;LIU Fuyao;PAN Yuan(Lower Extremity Trauma Orthopedics Department,Guizhou Hospital of Beijing Jishuitan Hospital,Guiyang 550000,Guizhou,China)

机构地区：[1]北京积水潭医院贵州医院下肢创伤骨科,贵阳550000

出　　处：《医学研究与战创伤救治》2023年第4期394-398,共5页Journal of Medical Research & Combat Trauma Care

摘　　要：目的探讨改良张力带钢丝联合带线锚钉内固定治疗髌骨下极粉碎性骨折的效果。方法回顾性分析2017年4月至2021年4月北京积水潭医院贵州医院下肢创伤骨科91例髌骨下极粉碎性骨折患者的临床资料。其中采用钢丝张力带联合微型钢板固定治疗患者45例(对照组),采用改良张力带钢丝联合带线锚钉内固定治疗46例(改良组)。对比两组手术及骨折愈合情况、术后疼痛、髌股关节功能、膝关节功能、膝关节活动度、并发症发生情况。结果两组切口长度、手术时间、术中出血量、骨折愈合时间比较,差异均无统计学意义(P>0.05)。两组术后12个月的Bostman髌骨骨折功能对比差异无统计学意义(P=0.598)。对照组术前、术后12个月的AKS评分、Lysholm评分差值明显高于改良组(P<0.05)。两组的膝关节活动度变化趋势差异有统计学意义(P=0.007)。改良组术后3个月、术后6个月膝关节活动度高于术后1个月(P<0.05)。对照组术后3个月、术后6个月膝关节活动度高于改良组(P=0.046、0.037)。两组总并发症发生率对比差异无统计学意义(χ2=0.050,P=0.822)。结论微型钢板联合钢丝张力带、改良张力带钢丝联合带线锚钉治疗髌骨下极粉碎性骨折均为安全、可靠的治疗方案,但微型钢板联合钢丝张力带在促进膝关节功能及膝关节活动度恢复方面更具优势,建议临床根据患者个体情况选择适合的固定方法。Objective To investigate the effect of modified tension band wire jointed suture anchor internal fixation in the treatment of the inferior patellar comminuted fracture.Methods There is a retrospective analysis of the clinical data for 91 patients with the inferior patellar comminuted fracture in the lower extremal trauma department of Guizhou Hospital,Beijing Jishuitan Hospital from April 2017 to April 2021.Among them,45 patients(Control group)were treated with wire tension band jointed microplate fixation,and 46 patients(Modified group)were treated with modified tension band wire jointed suture anchor internal fixation.The operation and fracture healing,postoperative pain,patellofemoral joint function,knee joint function,knee joint range of motion and complications were compared between the two groups.Results There were no significant differences in incision length,operation time,intraoperative blood loss and fracture healing time between the two groups(P>0.05).There was no significant difference in postoperative 12-month Bostman patellar fracture function between the two groups(P=0.598).The difference of preoperative and postoperative 12-month AKS score and Lysholm score in control group was significantly higher than that in modified group(P<0.05).There was significant difference between the two groups in the trend of knee joint motion(P=0.007).The knee joint motion at 3 months and 6 months after operation in the modified group was higher than 1 month after operation(P<0.05).The knee motion of the control group at 3 months and 6 months after operation was higher than that of the modified group(P=0.046,0.037).There was no significant difference in the total complication rate between the two groups(χ2=0.050,P=0.822).Conclusion Microplate jointed wire tension band and modified tension wire jointed suture anchor are safe and reliable treatment options for inferior patellar comminuted fracture,but microplate jointed wire tension band has more advantages in promoting the recovery of knee joint function and knee join

关 键 词：髌骨骨折 粉碎性骨折 内固定 效果 

分 类 号：R683[医药卫生—骨科学]