改良铆钉双滑轮固定与克氏针钢丝张力带固定治疗髌骨下极骨折疗效对比  

Comparison of the efficacy of modified rivet double pulley fixation and Kirschner wire tension band fixation for inferior pole patella fractures

作　　者：梅方宇 李永奖 白笋篷 MEI Fangyu;LI Yongjiang;BAI Sunpeng(Department of OrthopaedicⅡ,Tianmen First People’s Hospital,Tianmen 431700,China)

机构地区：[1]湖北省天门市第一人民医院汇侨院区骨科2区,431700

出　　处：《临床外科杂志》2025年第3期325-328,共4页Journal of Clinical Surgery

摘　　要：目的比较改良铆钉双滑轮固定方式与传统克氏针钢丝张力带治疗髌骨下极骨折的临床效果。方法2020年1月~2024年1月手术治疗的髌骨下极骨折病人78例,按固定方法不同分为两组,观察组39例,采用改良铆钉双滑轮固定,对照组39例,采用钢丝张力带固定。比较两组手术时间、住院时间、医疗费用,术后1个半月、3个月、6个月两组膝关节活动度,以及术后3个月、6个月膝关节lyshom功能评分。结果观察组手术时间为(62.58±6.37)分钟,对照组为(60.20±11.18)分钟;观察组住院时间为(6.45±1.35)天,对照组为(6.40±1.30)天,手术时间及住院时间两组比较差异无统计学意义(P>0.05)。观察组医疗总费用明显低于对照组(P<0.05);术后1个半月、3个月、6个月内膝关节活动度观察组均大于对照组(P<0.05),观察组术后3个月及6个月膝关节lyshom功能评分均明显高于对照组(P<0.05)。结论改良铆钉双滑轮手术对比克氏针张力带固定治疗髌骨下极骨折,无需二次手术取出内固定,术后膝关节活动度更优,术后膝关节功能评分更好。Objective To compare the clinical effects of improved rivet double pulley fixation method and traditional Kirschner wire tension band in the treatment of patellar lower pole fractures.Methods 78 patients with patellar inferior pole fractures who underwent surgery in our department between January 2020 and January 2024 and met the inclusion criteria were collected.Divided into two groups according to different fixing methods,the observation group(39 cases)were fixed by modified rivet double pulley,the control group(39 cases)were fixed by steel wire tension band.The operation time,hospital stay,medical expenses,knee motion of the two groups at 1.5 months,3 months and 6 months after surgery,and knee lyshom function score at 3 months and 6 months after surgery were compared between the two groups.Results The observation group had a surgery time of(62.58±6.37)minutes compared to the control group[(60.20±11.18)minutes],and the observation group had a hospital stay of(6.45±1.35)days compared to the control group[(6.40±1.30)days].There was no significant difference in surgical time and hospitalization time between the two group(P>0.05).The total medical expenses of the observation group were significantly lower than those of the control group(P<0.05).Knee joint activity in observation group was higher than that in control group at 1.5 months,3 months and 6 months after surgery(P<0.05),and knee lyshom function scores in observation group at 3 months and 6 months after surgery were significantly higher than those in control group(P<0.05).Conclusion Compared with Kirschner wire tension band fixation for the treatment of patellar lower pole fractures,the improved riveting double pulley surgery does not require secondary surgery to remove internal fixation,resulting in lower overall medical costs,better postoperative knee joint mobility,and better postoperative knee joint function scores.The improved riveting double pulley surgery has more advantages in treating patellar lower pole fractures compared to traditional Kirsch

关 键 词：髌骨下极骨折 改良铆钉双滑轮固定 克氏针张力带固定 

分 类 号：R68[医药卫生—骨科学]