关节镜下张力带固定治疗髌骨骨折  

Arthroscopy tension band fixation for treatment of the patellar fracture

作　　者：白尚 张国鹏 李健 马大年 张峰 李红玲 李先仙 赵喆 BAI Shang;ZHANG Guo-peng;LI Jian;MA Da-nian;ZHANG Feng;LI Hong-ling;LI Xian-xian;ZHAO Zhe(Dept of Orthopaedics,the People′s Hospital of Xuyi County,Huai′an,Jiangsu 211700,China)

机构地区：[1]盱眙县人民医院骨科,江苏淮安211700

出　　处：《临床骨科杂志》2024年第1期107-111,共5页Journal of Clinical Orthopaedics

摘　　要：目的探讨关节镜下张力带固定治疗髌骨骨折的疗效。方法采用关节镜下张力带固定治疗30例髌骨骨折患者。记录手术情况、骨折愈合情况、功能康复情况、并发症发生情况,采用Bostman评分评价膝关节功能的疗效。结果患者均获得随访,时间6~12(10.0±2.2)个月。手术时间40~60(46.8±5.4)min,切口总长度1.8~3.0(2.4±0.4)cm。骨痂形成时间1~3(1.9±0.9)个月,骨折愈合时间3~6(4.0±0.8)个月。术后不负重下地时间2~6(3.2±1.2)d,术后完全负重时间1~2(1.6±0.5)个月。末次随访时,膝关节屈曲110°~135°(129.0°±6.5°)、伸直0°~5°(1.9°±1.7°);Bostman评分18~30(27.0±3.0)分,其中优17例,良12例,差1例,优良率29/30。术后1例膝关节髌前疼痛,1例前内侧入路处皮肤感觉减退,2例钢缆滑脱,均未发生切口感染、内固定断裂、下肢深静脉血栓、骨不连、创伤性关节炎等并发症。结论关节镜下张力带固定治疗髌骨骨折,具有创伤小、并发症少、骨折愈合快、关节功能恢复理想等优点。Objective To investigate the effect of tension band fixation under arthroscopy on patellar fracture.Methods The 30 patients with patellar fractures were treated with tension band fixation under microscopy.The operation situation,fracture healing,functional rehabilitation and complications were recorded,and the effect of knee function was evaluated by Bostman score.Results All patients were followed up for 6~12(10.0±2.2)months.The operation time was 40~60(46.8±5.4)min,and the total incision length was 1.8~3.0(2.4±0.4)cm.The time of callus formation was 1~3(1.9±0.9)months,and fracture healing time was 3~6(4.0±0.8)months.The start time of walking without weight-bearing was 2~6(3.2±1.2)d after operation,and the start time of walking with full weight-bearing was 1~2(1.6±0.5)months after operation.At the last follow-up,the knee joint was flexion with 110°~135°(129.0°±6.5°)and extension with 0°~5°(1.9°±1.7°).Bostman scores were 18~30(27.0±3.0)points,of which 17 cases were excellent,12 cases were good,and 1 case was poor,the excellent-good rate was 29/30.Postoperative prepatellar pain of knee joint occurred in 1 case,hypoaesthesia of skin at anteromedial approach site occurred in 1 case,and slipping of steel cable existed in 2 cases.There were no complications with incision infection,internal fixation rupture,deep vein thrombosis of lower extremity,nonunion,traumatic arthritis.Conclusions Arthroscopy tension band fixation in the treatment of patellar fracture has the advantages of less trauma,fewer complications,fast fracture healing and ideal joint function recovery.

关 键 词：髌骨骨折 关节镜检查 张力带固定 

分 类 号：R683.42[医药卫生—骨科学] R687.4[医药卫生—外科学] R687.3[医药卫生—临床医学]