RockwoodⅢ型髌骨骨折采取带线锚钉Krackow缝合法的临床研究  

Clinical Study on the Treatment of Rockwood TypeⅢPatellar Fracture by Krackow Suture with Suture Anchor

作　　者：刘双来 赵为夏 万美荣 LIU Shuanglai;ZHAO Weixia;WAN Meirong(Jiangxi Jiayou Shuguang Orthopaedic Hospital,Nanchang 333000,China;不详)

机构地区：[1]江西嘉佑曙光骨科医院,江西南昌333000 [2]南昌市西湖区桃花镇卫生院

出　　处：《中国医学创新》2023年第31期28-32,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(SKJP220217705)。

摘　　要：目的:探究RockwoodⅢ型髌骨骨折采取带线锚钉Krackow缝合法治疗的临床效果。方法:选取江西嘉佑曙光骨科医院2020年1月—2022年4月骨科收治的60例RockwoodⅢ型髌骨骨折患者为研究对象,采用随机数字表法分为观察组(n=30)与对照组(n=30)。对照组采用髌骨爪内固定术治疗,观察组采用带线锚钉Krackow缝合法治疗。比较两组术前与术后2、4、8个月伤侧Bostman髌骨骨折功能评分、术前及术后1周、2周、1个月视觉模拟评分法(visual analogue scale,VAS)评分,比较两组术前与术后5 d白介素-6(IL-6)、白介素-10(IL-10)及肿瘤坏死因子-α(TNF-α)水平,比较两组手术情况、临床疗效和并发症。结果:观察组术后2、4个月Bostman髌骨骨折功能评分均高于对照组,术后1、2周VAS评分均低于对照组(P<0.05);两组术前IL-6、IL-10和TNF-α水平比较,差异均无统计学意义(P>0.05);术后5 d观察组IL-6和TNF-α水平均较对照组更低,但观察组IL-10水平较对照组更高(P<0.05)。观察组术中出血量少于对照组,骨折愈合时间短于对照组(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05)。观察组优良率为93.33%,显著高于对照组的73.33%(χ^(2)=4.320,P=0.038)。观察组并发症发生率(3.33%)低于对照组(16.67%),但两组比较,差异无统计学意义(χ^(2)=1.667,P=0.967)。结论:带线锚钉Krackow缝合法治疗RockwoodⅢ型髌骨骨折较传统髌骨爪内固定术的临床效果更好,能降低术中出血量,加快患者恢复。Objective:To investigate the clinical effect of Rockwood typeⅢpatellar fracture by Krackow suture with suture anchor.Method:A total of 60 patients with Rockwood typeⅢpatellar fracture admitted to the Department of Orthopedics of Jiangxi Jiayou Shuguang Orthopaedic Hospital from January 2020 to April 2022 were selected as the study objects,and were divided into observation group(n=30)and control group(n=30)according to random number table method.The control group was treated with internal fixation with patellar claw,and the observation group was treated with Krackow suture with suture anchor.The Bostman patellar fracture function scores before and 2,4 and 8 months after surgery and the visual analogue scale(VAS)scores before and 1 week,2 weeks and 1 month after surgery were compared between the two groups.The levels of interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)were compared between the two groups before and 5 days after surgery.The operation status,clinical efficacy and complications were compared between the two groups.Result:The Bostman patellar fracture function scores in the observation group were higher than those in the control group at 2 and 4 months after surgery,and the VAS scores in the observation group were lower than those in the control group at 1 week and 2 weeks after surgery(P<0.05).There were no significant differences in the levels of IL-6,IL-10 and TNF-αbetween two groups before surgery(P>0.05).5 days after surgery,the levels of IL-6 and TNF-αin the observation group were lower than those in the control group,and the level of IL-10 in the observation group was higher than that in the control group(P<0.05).The intraoperative bleeding volume and fracture healing time of observation group were shorter than those of control group(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).The excellent and good rate of the observation group was 93.33%,which was significantly higher than 73.33%of the control group(χ^(2)=4.320

关 键 词：髌骨骨折 髌骨爪 RockwoodⅢ型 带线锚钉 Krackow缝合 

分 类 号：R687.3[医药卫生—骨科学]