关节镜下螺钉张力带内固定治疗髌骨横行骨折  

Arthroscopic internal fixation with screw tension band for the treatment of transverse patellar fracture

作　　者：王磊涛 田巧兰 WANG Leitao;TIAN Qiaolan(Department of Trauma and Orthopedics,Puyang Traditional Chinese Medicine Hospital,Puyang,Henan,457000,China)

机构地区：[1]濮阳市中医医院创伤骨科,河南濮阳457000

出　　处：《实用手外科杂志》2024年第4期503-506,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨关节镜联合螺钉张力带内固定治疗髌骨横行骨折患者的临床疗效。方法回顾性分析濮阳市中医医院2019年4月-2021年4月收治的92例髌骨横行骨折患者病例资料,按手术方案不同分两组。以接受关节镜联合螺钉张力带内固定治疗的46例为A组,以接受切开复位克氏针张力带内固定治疗的46例为B组。对比两组手术指标、膝关节活动范围优良率、手术前后Lysholm膝关节评分、视觉模拟评分法(VAS)评分、体液免疫功能[免疫球蛋白(Ig)A、IgG、IgM]水平、并发症发生率。结果A组切口总长度、手术及住院用时较B组更短,术中失血量较B组更低(P<0.05);A组膝关节活动范围优良率95.65%(44/46),相较B组80.43%(37/46)更高(P<0.05);A组术后3个月Lysholm评分较B组更高,VAS评分较B组更低(P<0.05);A组术后1 d血清IgA、IgG、IgM水平较B组更高(P<0.05);A组并发症发生率2.17%(1/46),相较于B组17.39%(8/46)更低(P<0.05)。结论与切开复位克氏针张力带内固定治疗髌骨横行骨折相比,经关节镜联合螺钉张力带内固定治疗更有助于优化手术指标、提高膝关节功能及活动范围、降低并发症风险、减轻疼痛程度,且对机体体液免疫功能产生影响更小。Objective To explore the effect of arthroscopy combined with screw tension band internal fixation in the treatment of patellar transverse fracture.Methods The data of 92 patients with patellar transverse fracture in our hospital(April 2019~April 2021)were retrospectively collected and divided into 2 groups according to different surgical protocols.Forty-six patients receiving arthroscopy combined with screw tension band internal fixation were classified as group A,and 46 patients receiving open reduction Kirschner wire tension band internal fixation were classified as group B.Surgical indicators,excellent and good rate of knee range of motion,Lysholm knee score before and after surgery,visual analogue scale(VAS)score,humoral immune function[immunoglobulin(Ig)A,IgG,IgM]level,and complication rate were compared between the two groups.Results The total incision length,operation time and hospitalization time in group A were shorter than those in group B,and the intraoperative blood loss was lower than those in group B(P<0.05).The excellent rate of knee motion range in group A was 95.65%(44/46)higher than that in group B(80.43%(37/46)(P<0.05)).Lysholm score of group A was higher and VAS score of group B was lower 3 months after operation(P<0.05).The serum levels of IgA,IgG and IgM in group A were higher than those in group B one day after surgery(P<0.05).The complication rate of group A was 2.17%(1/46)lower than that of group B 17.39%(8/46)(P<0.05).Conclusion Compared with open reduction Kirschner wire tension band internal fixation in the treatment of patellar transverse fracture,arthroscopy combined with screw tension band internal fixation is more helpful to optimize the surgical indicators,improve the knee function and range of motion,reduce the risk of complications,alleviate the degree of pain,and has less influence on the body humoral immune function.

关 键 词：关节镜 并发症 髌骨横行骨折 体液免疫功能 

分 类 号：R687.3[医药卫生—骨科学]