张力带加强间断垂直钢丝固定技术联合Krackow缝合治疗髌骨下极骨折的临床价值及安全性评价  

Clinical value and safety evaluation of tension band reinforced separate vertical wiring combined with Krackow suture in treatment of inferior patellar fractures

作　　者：王守宝 刘蔚楠 张振清 郝成俊 吴自博 WANG Shoubao;LIU Weinan;ZHANG Zhenqing;HAO Chengjun;WU Zibo(Department of Orthopaedics,Huai'an Hospital Affiliated to Yangzhou University(the Fifth People's Hospital of Huai'an),Huaian,Jiangsu 223300,China;不详)

机构地区：[1]扬州大学附属淮安医院(淮安市第五人民医院)骨科,江苏223300 [2]福建中医药大学附属人民医院(福建省人民医院)骨伤科,福建福州350000

出　　处：《中国骨与关节损伤杂志》2025年第2期132-136,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的评价8字形张力带加强间断垂直钢丝固定技术联合Krackow缝合治疗髌骨下极骨折的临床应用价值及安全性。方法回顾性分析自2021-01—2023-04诊治的20例(20膝)髌骨下极骨折,采用8字形张力带加强间断垂直钢丝固定技术联合Krackow缝合治疗,观察切口愈合情况、骨折愈合情况、膝关节功能、内固定相关并发症发生情况。结果20例均获得随访,随访时间8~12个月,平均10个月。术后切口均一期愈合,无皮肤激惹、脂肪液化、线结反应、切口感染、下肢深静脉血栓形成等并发症发生。随访期间未出现深部感染、内固定物松动断裂、骨折不愈合等并发症。骨折均愈合良好,愈合时间10~12周,平均11周。末次随访时膝关节活动度恢复满意,膝关节活动度为112°~132°,平均127.5°;膝关节疼痛症状消失,疼痛VAS评分0~1分,平均0.1分。末次随访时膝关节功能B?stman评分为28~30分,平均28.5分;膝关节KOOS评分为90~98分,平均94.9分;屈膝30°侧位X线片上Insall-Salvati指数为1.0~1.2,平均1.1。结论8字形张力带加强间断垂直钢丝固定技术联合Krackow缝合治疗髌骨下极骨折安全、有效,固定可靠,具有手术操作简单、创伤小、并发症少等优点,患者可以早期功能锻炼并快速康复。ObjectiveTo evaluate the clinical value and safety of 8-shaped tension band reinforced separate vertical wiring combined with Krackow suture in the treatment of inferior patellar fractures.MethodsTwenty patients(20 knees)with inferior patellar fractures treated with 8-shaped tension band reinforced separate vertical wiring combined with Krackow suture from January 2021 to April 2023 were analyzed retrospectively.All patients were followed up to observe incision healing,fracture healing,knee joint function and complications related to internal fixation.ResultsAll 20 cases were followed up for 8 to 12months,with an average of 10 months.All incisions healed in one stage after operation,without complications such as skin irritation,fat liquefaction,suture knot reaction,incision infection,and deep vein thrombosis of lower limbs.During the follow-up period,no complications such as deep infection,loosening and rupture of internal fixation,and non-union of fractures occurred.All fractures healed well,and the healing time was 10 to 12 weeks,with an average of 11 weeks.At the last follow-up visit,the range of motion of the knee joint from 112°to 132°with an average of 127.5°was satisfactory;the knee joint pain disappeared,and the pain VAS score was 0 to 1,with an average of 0.1.At the last follow-up visit,the B?stman score of knee joint function was 28-30 points,with an average of 28.5 points;the KOOS score of knee joint was 90-98 points,with an average of 94.9points;and the Insall-Salvati index on lateral X-ray with 30°flexion was 1.0-1.2,with an average of 1.1.ConclusionThe 8-shaped tension band reinforced separate vertical wiring combined with Krackow suture is safe,effective and reliable in the treatment of patella fractures.It has the advantages of simple surgical operation,less trauma,and few complications.Patients can exercise early functional exercise and recover quickly.

关 键 词：髌骨下极骨折 8字形张力带 间断垂直钢丝固定技术 KRACKOW缝合法 

分 类 号：R687.3[医药卫生—骨科学]