解剖型锁定钢板治疗RockwoodⅠ~Ⅲ型髌骨骨折  

Clinical application of anatomical locking plate in treatment of Rockwood typeⅠ-Ⅲpatella fractures

作　　者：李艺 阿里木江·阿不来提[1] 买买提明·赛依提[1] 程二林 艾合买提江·玉素甫[1,2] LI Yi;Alimujiang·Abulaiti;Maimaitiming·Saiyiti;CHENG Erlin;Aihemaitijiang·Yusufu(Department of Microsurgical Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang,830054,P.R.China;Key Laboratory of Trauma Repair and Reconstruction in Xinjiang Uygur Autonomous Region,Urumqi Xinjiang,830054,P.R.China)

机构地区：[1]新疆医科大学第一附属医院显微修复外科,乌鲁木齐830054 [2]新疆维吾尔自治区创伤修复重建重点实验室,乌鲁木齐830054

出　　处：《中国修复重建外科杂志》2024年第4期422-425,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨解剖型锁定钢板治疗RockwoodⅠ~Ⅲ型髌骨骨折疗效。方法回顾性分析2021年11月—2023年1月收治且符合选择标准的16例髌骨骨折患者临床资料。男14例,女2例;年龄19~72岁,平均44.5岁。致伤原因:跌伤12例,交通事故伤4例。骨折Rockwood分型:Ⅰ型2例,Ⅱ型9例,Ⅲ型5例。受伤至手术时间6~15 d,平均9 d。术中骨折复位后,选择合适形状解剖型锁定钢板修剪塑形后内固定。记录手术时间、术中出血量以及切口愈合情况;采用Lysholm评分、Böstman髌骨骨折疗效评分、膝关节活动度以及疼痛视觉模拟评分(VAS)评价膝关节功能及疼痛程度;X线片复查骨折复位以及愈合情况。结果手术时间65~100 min,平均75.3 min;术中出血量10~35 mL,平均25.6 mL。术后切口均Ⅰ期愈合。患者均获随访,随访时间11~26个月,平均19.7个月。X线片复查示骨折复位满意,均达骨性愈合,愈合时间3~5个月。末次随访时,Lysholm评分为90~95分,平均93.0分;Böstman髌骨骨折疗效评分为27~30分,平均28.8分,其中优12例、良4例;VAS评分为0~1分,平均0.3分;健、患侧膝关节活动度差异无统计学意义[145°(140°,150°)vs 145°(140°,145°);Z=1.890,P=0.059]。结论RockwoodⅠ~Ⅲ型髌骨骨折采用解剖型锁定钢板治疗可获得坚强固定,且手术创伤小,膝关节功能恢复快,术后疼痛程度轻。Objective To investigate the effectiveness of anatomical locking plate in the treatment of Rockwood typeⅠ-Ⅲpatella fractures.Methods The clinical data of 16 patients with patella fractures who were admitted between November 2021 and January 2023 and met the selection criteria was retrospectively analyzed.There were 14 males and 2 females,with an average age of 44.5 years(range,19-72 years).Causes of injuries included tumble in 12 cases and traffic accident in 4 cases.The fractures were rated as typeⅠin 2 cases,typeⅡin 9 cases,and typeⅢin 5 cases according to Rockwood classification criteria.The time from injury to operation ranged from 6 to 15 days,with an average of 9 days.After fracture reduction,an appropriate anatomical locking plate was selected for internal fixation.The operation time,intraoperative blood loss,and incision healing were recorded;the Lysholm score,Böstman patella fracture efficacy score,knee joint mobility,and visual analogue scale(VAS)score were used to evaluate the knee joint function and pain degree;X-ray films were used to review the fracture reduction and healing.Results The operation time was 65-100 minutes(mean,75.3 minutes);the intraoperative blood loss was 10-35 mL(mean,25.6 mL).All incisions healed by first intention after operation.All patients were followed up 11-26 months(mean,19.7 months).X-ray films showed that the fractures were reduced satisfactorily,and all achieved bony healing with healing time of 3-5 months.At last follow-up,the Lysholm score was 90-95(mean,93.0);the Böstman patella fracture efficacy score was 27-30(mean,28.8),of which 12 cases were excellent and 4 were good;the VAS score was 0-1(mean,0.3).There was no significant difference in the range of motion of the knee joint between the healthy and affected sides[145°(140°,150°)vs 145°(140°,145°);Z=1.890,P=0.059].Conclusion Choosing anatomical locking plates for Rockwood typeⅠ-Ⅲpatella fractures can achieve strong fixation with minimal surgical trauma,rapid recovery of knee joint function,and

关 键 词：髌骨骨折 RockwoodⅠ~Ⅲ型骨折 解剖型锁定钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]