空心螺钉联合带线锚钉固定治疗髌骨粉碎性骨折的疗效分析  

Cannulated screws combined with suture anchors for comminuted patellar fractures

作　　者：王小虎[1] 任雨昊 马路遥 尹芸生[1] 刘晋元[1] 吕欣[1] Wang Xiaohu;Ren Yuhao;Ma Luyao;Yin Yunsheng;Liu Jinyuan;Lyu Xin(Department of Orthopaedics,The Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院骨科,太原030001

出　　处：《中华创伤骨科杂志》2024年第6期505-511,共7页Chinese Journal of Orthopaedic Trauma

基　　金：山西省卫生健康委员会"四个一批"创新计划项目(2020TD18)。

摘　　要：目的:探讨空心螺钉联合带线锚钉固定治疗髌骨粉碎性骨折的临床疗效。方法:回顾性分析2020年1月至2023年6月期间山西医科大学第二医院骨科收治的72例髌骨粉碎性骨折患者资料。根据手术方式不同分为两组:A组34例,男22例,女12例;年龄49(39,58)岁;骨折AO分型:34-C2型7例,34-C3型27例;采用空心螺钉联合带线锚钉内固定治疗。B组38例,男19例,女19例;年龄55(40,62)岁;骨折AO分型:34-C2型11例,34-C3型27例;采用空心螺钉联合钛缆内固定治疗。比较两组患者术后膝关节活动度、骨折愈合时间、并发症发生情况、软组织激惹率、二次手术率,以及末次随访时疼痛视觉模拟评分(VAS)、膝关节Bostman评分及Levack评分等。结果:两组患者术前一般资料及随访时间比较差异均无统计学意义( P>0.05),具有可比性。两组患者术后膝关节活动度、骨折愈合时间、末次随访时膝关节Bostman评分及Levack评分比较差异均无统计学意义( P>0.05)。末次随访时A组患者的疼痛VAS评分为0.0(0.0,1.0)分,软组织激惹率为0%(0/34),均显著低于B组患者[1.0(0.0,1.3)分、15.8%(6/38)],差异均有统计学意义( P<0.05)。A组患者的总体并发症发生率、二次手术率分别为5.9%(2/34)、2.9%(1/34),均低于B组患者[21.1%(8/38)、15.8%(6/38)],但差异均无统计学意义( P>0.05)。 结论:与空心螺钉联合钛缆相比,空心螺钉联合带线锚钉固定治疗髌骨粉碎性骨折的疗效相当,且后者可以降低患者软组织激惹率,缓解患者疼痛,提高患者的生活质量。ObjectiveTo evaluate the clinical efficacy of cannulated screws combined with suture anchor in the treatment of comminuted patellar fractures.MethodsA retrospective study was conducted to analyze the data of 72 patients who had been admitted to Department of Orthopaedics,The Second Hospital of Shanxi Medical University for comminuted patellar fractures between January 2020 and June 2023.The patients were divided into 2 groups based on the surgical techniques used.In group A of 34 patients subjected to fixation using cannulated screws combined with suture anchors,there were 22 males and 12 females with an age of 49(39,58)years,and 7 cases of AO type 34-C2 and 27 cases of AO type 34-C3.In group B of 38 patients subjected to fixation using cannulated screws combined with titanium cables,there were 19 males and 19 females with an age of 55(40,62)years,and 11 cases of AO type 34-C2 and 27 cases of AO type 34-C3.Comparisons were made between the 2 groups regarding general preoperative data,postoperative range of knee motion,fracture healing time,complications,soft tissue irritation,secondary surgery,postoperative pain assessed by visual analogue scale(VAS),postoperative Bostman knee score,and postoperative Levack knee score.ResultsThe 2 groups were comparable because there were no statistically significant differences in the general preoperative data and follow-up time between them(P>0.05).There were no statistically significant differences between the 2 groups either in postoperative range of knee motion,fracture healing time,or Bostman knee score or Levack knee score at the last follow-up(all P>0.05).In group A,the VAS pain score and the rate of soft tissue irritation at the last follow-up were respectively 0.0(0.0,1.0)and 0%(0/34),significantly lower than those in group B[1.0(0.0,1.3)and 15.8%(6/38)](P<0.05).The overall incidence of complications and secondary surgery rate in group A were respectively 5.9%(2/34)and 2.9%(1/34),lower than those in group B[21.1%(8/38)and 15.8%(6/38)],but showing no statistically signif

关 键 词：髌骨 骨折 骨折固定术 内 骨钉 带线锚钉 

分 类 号：R687.3[医药卫生—骨科学]