锚钉联合聚酯不可吸收缝合线Krachow缝合治疗髌骨下极粉碎性骨折疗效分析  

Efficacy analysis of anchor combined with polyester non-absorbable suture and Krachow suture in the treatment of comminuted fractures of inferior pole of patella

作　　者：邓钰泓 邹刚 金瑛 DENG Yuhong;ZOU Gang;JIN Ying(Department of Orthopedics,Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义医科大学附属医院关节外科,贵州遵义563000

出　　处：《医药前沿》2025年第12期52-55,共4页Journal of Frontiers of Medicine

摘　　要：目的观察锚钉联合聚酯不可吸收缝合线Krachow缝合治疗髌骨下极粉碎性骨折的临床疗效。方法选取遵义医科大学附属医院2020年1月—2022年1月收治的30例髌骨下极粉碎性骨折患者作为研究对象。采用聚酯不可吸收缝合线联合锚钉固定并使用Krackow缝合技术进行复位固定。术后积极抗感染治疗,消除肿胀,加强换药。采用Bostman髌骨骨折功能评分评价临床疗效,采用膝关节损伤和骨关节炎评分(KOOS)评估症状程度和功能状态,通过X线片观察骨折愈合情况和内固定松动、移位、断裂等情况,测量患者双侧膝关节的最大主动屈曲角度,观察骨折愈合及并发症发生情况。结果30例患者的切口均Ⅰ期愈合,术中无重要神经、血管损伤等严重并发症,术后无关节及伤口感染,无内固定松动、移位、断裂等并发症,术后3个月X线片均提示髌骨骨性愈合。术后12个月Bostman髌骨骨折功能评分为(27.5±1.5)分;优25例、良5例,优良率为100%。术后12个月KOOS评分为(92.6±4.1)分。术后1个月,患者的患侧与健侧膝关节最大主动屈曲角度比较,差异有统计学意义(P<0.05);术后3、6、12个月,患者的患侧与健侧膝关节最大主动屈曲角度比较,差异无统计学意义(P>0.05)。结论锚钉联合聚酯不可吸收缝合线Krackow缝合治疗髌骨下极粉碎性骨折效果满意,可减少传统钢丝对骨折块应力产生的切割,在术后进行功能锻炼时也能降低骨折再移位的风险。Objective To observe the clinical efficacy of anchor combined with polyester non-absorbable suture and Krachow suture in the treatment of comminuted fractures of inferior pole of patella.Methods A total of 30 patients with comminuted fractures of inferior pole of patella admitted to the Affiliated Hospital of Zunyi Medical University from January 2020 to January 2022 were selected as the study subjects.Polyester non-absorbable suture combined with suture anchor fixation and Krackow suture technique were used for reduction and fixation.Postoperative management included active anti-infection treatment,swelling reduction,and enhanced wound care.The clinical efficacy was evaluated using the Bostman patellar fracture functional score,and the symptom severity and functional status were assessed using the Knee Injury and Osteoarthritis Outcome Score(KOOS),X-ray imaging was used to observe fracture healing and complications such as loosening,displacement or breakage of internal fixation,the maximum active flexion angle of bilateral knee joints was measured,and the fracture healing and complications were observed.Results All 30 incisions healed primarily,with no severe intraoperative complications such as major nerve or vascular injuries.Postoperatively,there were no joint or wound infections,and no complications such as loosening,displacement or breakage of internal fixation,X-ray imaging at 3 months postoperatively showed bony healing of the patella in all cases.At 12 months postoperatively,the Bostman patellar fracture functional score was(27.5±1.5)points,with 15 cases rated as excellent and 5 cases as good,the excellent and good rate was 100%.The KOOS score at 12 months postoperatively was(92.6±4.1)points.There was a statistically significant difference in the maximum active flexion angle between the affected side and the healthy side of the knee joint at 1 month postoperatively(P<0.05);there was no significant difference in the maximum active flexion angle between the affected side and the healthy side of the knee

关 键 词：高强度缝线 髌骨下极骨折 锚钉 Krachow缝合 髌韧带 

分 类 号：R683[医药卫生—骨科学]