两种手术方式治疗青少年急性髌骨脱位合并髌骨软骨骨折的疗效分析  

Efficacy of Two Surgical Methods in the Treatment of Acute Patellar Dislocation Complicated with Patellar Cartilage Fracture in Adolescents

作　　者：钟勇 梁肇星 谢宗林 ZHONG Yong;LIANG Zhaoxing;XIE Zonglin(Ganxian District People’s Hospital,Ganzhou Jiangxi 341100,China)

机构地区：[1]赣县区人民医院,江西赣州341100

出　　处：《现代诊断与治疗》2023年第14期2061-2064,共4页Modern Diagnosis and Treatment

摘　　要：目的探讨两种手术方式在青少年急性髌骨脱位合并髌骨软骨骨折患者中的临床疗效。方法选取2019年4月至2020年6月我院收治的青少年急性髌骨脱位合并髌骨软骨骨折患者50例,根据治疗方法不同分为对照组和观察组各25例。对照组采用经髌骨超强缝合线内固定骨折块治疗,观察组采用髌骨软骨骨折块去除加创面微骨折术治疗,两组术后均进行2年门诊追踪随访,比较两组手术指标、视觉模拟疼痛(VAS)、Lysholm、膝关节损伤和骨关节炎结果评分(KOOS评分)及术后并发症。结果手术7 d后,两组VAS及Lysholm量表评分均得到改善,且观察组VAS评分低于对照组,Lysholm量表评分高于对照组,差异有统计学意义(P<0.05)。观察组骨折愈合时间、术中出血量少于对照组,差异有统计学意义(P<0.05)。治疗3个月、6个月、1年、2年后,两组KOOS评分均得到升高,且观察组治疗2年后KOOS评分高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,无显著差异(P>0.05)。结论髌骨软骨骨折块去除加创面微骨折术用于青少年急性髌骨脱位合并髌骨软骨骨折患者中,手术创伤较小,有助于减轻患者疼痛,促进骨折脱位及软骨骨折恢复,未增加手术并发症,值得推广应用。Objectives To investigate the clinical efficacy of two surgical methods in adolescent patients with acute patellar dislocation complicated with patellar cartilage fracture.Methods A total of 50 adolescent patients with acute patellar dislocation complicated with patellar cartilage fracture admitted to our hospital in Ganzhou City from April 2019 to June 2020 were selected and divided into control group and observation group according to different methods,with 25 patients in each group.The control group was treated with internal fixation of fracture fragments through patellar super strong sutures,while the observation group was treated with patellar cartilage fracture fragment removal and wound microfracture surgery.Both groups underwent a 2-year outpatient follow-up.The surgical indicators,visual simulated pain(VAS),Lysholm,knee joint injury and osteoarthritis outcome score(KOOS score),and postoperative complications were compared between the two groups.Results After 7 days of surgery,the VAS and Lysholm scale scores of both groups improved,and the VAS score of the observation group was significantly lower than that of the control group,while the Lysholm scale score was significantly higher than that of the control group(P<0.05).The fracture healing time and intraoperative blood loss in the observation group were significantly less than those in the control group(P<0.05).After 3 months,6 months,1 year,and 2 years of treatment,the KOOS scores of both groups were increased,and the pain,symptom part,daily living ability,knee joint related quality of life,and sports and entertainment parts of the observation group were significantly higher than those of the control group after 2 years of treatment(P<0.05).There was no significant difference in the incidence of perioperative infection,fixation failure,delayed healing,neurovascular injury,and healing deformity between the two groups(P>0.05).Conclusions The removal of patellar cartilage fracture fragment and wound microfracture surgery is suitable for adolescent patient

关 键 词：青少年 急性髌骨脱位 髌骨软骨骨折 经髌骨超强缝合线内固定骨折块 髌骨软骨骨折块去除加创面微骨折术 

分 类 号：R454[医药卫生—治疗学]