带线锚钉联合髌胫减张带环扎治疗髌骨下极骨折的临床疗效观察  

Clinical Observation of the Effectiveness of Suture Anchor Combined with Patella-Tibial Tension-Reducing Belt Cerclage in Treating Fractures of the Lower Pole of the Patella

作　　者：陈谱 谢杰伟[1] 冯恩辉 梁家畅 黄伟明[1] 何剑波[1] 郑瑞端 管华[1] CHEN Pu;XIE Jiewei;FENG Enhui;LIANG Jiachang;HUANG Weiming;HE Jianbo;ZHENG Ruiduan;GUAN Hua(Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广东省中医院,广州510120

出　　处：《中国中医骨伤科杂志》2025年第1期69-73,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：广东省软科学研究计划项目(2020A1414040031);广东省中医院中医药科学技术研究拔尖人才专项项目(BJ2022YL13);2023年度广州市基础与应用基础研究专题项目(2023A04J0462);广东省中医院中医药科学技术研究专项资助项目(YN2023QN08)。

摘　　要：目的:探讨带线锚钉联合髌胫减张带环扎治疗髌骨下极骨折的临床疗效。方法:回顾性分析2018年1月至2023年5月用带线锚钉联合髌胫减张带环扎治疗的髌骨下极骨折患者22例,其中男9例,女13例;年龄为29~77岁,平均为(55.82±13.22)岁。左侧髌骨下极骨折10例,右侧12例,均为闭合性骨折。所有患者均早期进行负重及膝关节活动度训练,评估患者膝关节活动度、疼痛视觉模拟量表(VAS)评分、Böstman评分和并发症情况。结果:所有患者均获得随访,术后随访时间为12~64个月,平均为(36.55±17.68)个月。术后所有切口均Ⅰ期愈合,无骨折移位、骨折不愈合、膝关节伸直受限等并发症。术后X线检查结果显示骨折愈合良好。末次随访时患侧膝关节活动度及Insall-Salvati指数与健侧相比差异无统计学意义(P>0.05);术后Böstman评分为(28.05±1.66)分,其中优15例,良7例,差0例,优良率为100%。结论:带线锚钉联合髌胫减张带环扎可以有效固定髌骨下极骨折,允许早期进行功能锻炼,膝关节功能恢复满意,是一种安全有效的治疗方法。Objective:To investigate the clinical efficacy of suture anchor combined with patella-tibial tension-reducing belt cerclage in treating fractures of the lower pole of the patella.Methods:A retrospective analysis was conducted on 22 patients with fractures of the lower pole of the patella treated with suture anchor combined with patella-tibial tension-reducing belt cerclage from January 2018 to May 2023.Among them,there were 9 males and 13 females,with an average age of(55.82±13.22)years old(range 2977 years old).There were 10 cases of left patella lower pole fractures and 12 cases of right,all of which were closed fractures.All patients underwent early weight-bearing and knee range of motion exercises.The knee range of motion,visual analogue scale(VAS)for pain,Böstman score,and complications were evaluated.Results:All patients were followed up for 12 to 64 months,with an average follow-up time of(36.55±17.68)months.All incisions healed in stageⅠafter surgery,with no complications such as fracture displacement,nonunion,or limited knee extension.Postoperative X-ray results showed good fracture healing.At the final follow-up,there was no significant difference in knee range of motion and Insall-Salvati index between the affected side and the healthy side.The postoperative Böstman score was(28.05±1.66)points,with 15 excellent cases,7 good cases,and 0 poor case,achieving a 100%excellent and good rate.Conclusion:The combination of suture anchor and patella-tibial tension-reducing belt cerclage can effectively fix fractures of the lower pole of the patella,allowing early functional exercises and satisfactory recovery of knee function.It is a safe and effective treatment method.

关 键 词：髌骨下极骨折 带线锚钉 髌胫减张带 内固定 快速康复外科理念 

分 类 号：R683.42[医药卫生—骨科学]