摘要
目的探讨经皮微创张力带崮定术治疗髌骨横形骨折的临床疗效。方法回顾性分析2009年5月至2011年6月收治的51例髌骨横形骨折患者资料，根据固定方式不同分为微创组（采用微创张力带同定术）和切开复位组（采用切开复位AO张力带刚定术），微创组27例，男19例，女8例；年龄19-43岁，平均（28．3±3．2）岁。切开复位组24例，男18例，女6例；年龄21-44岁，平均（29．1±3．5）岁。比较两组患者的骨折复位时问、骨折愈合时间、屈膝90。疼痛视觉模拟评分（VAS）、大腿周径较健侧下降值、关节活动度较健侧下降值及Lysholm膝关节功能评分等。结果微创组术后骨折复位优良率（88．9％）高于切开复位组（79．2％），骨折愈合时间[（10．9±1．3）周]短于切开复位组[（12．5±1．5）周]，术后1周、1个月屈膝90。疼痛VAS评分、术后1、3、6、12个月大腿周径较健侧下降值均低于切开复位组，术后1、3个月火节活动度较健侧下降值、Lvsholm膝关节功能评分明硅优于切开复位组，以上项目两组问比较差异均有统计学意义（P〈0．05）；而术后3个月屈膝90。疼痛VAS评分、术后6、12个月Lysholm膝关节功能评分两组比较差异均无统计学意义（P〉0．05）。结论微创张力带固定术具有手术创伤小、在关节镜辅助下骨折复位更加准确、骨折愈合时间短等优点，有利于患者早期进行功能锻炼，适用于断端分离〈3cm的髌骨横形骨折。
Objective To evaluate the clinical value of figure-of-eight wiring in the arthroscopieal- ly-assisted internal fixation of transverse patellar fractures. Methods The clinical data were reviewed of 51 patients with transverse patellar fractures who had been treated in our department from May 2009 through June 2011. They were divided into group A using figure-of-eight wiring （percutaneous tension band） （PFB） and group B using open reduction and internal fixation with AO wire tension band （ORIF） . In group A, there, were 27 patients, 19 men and 8 women, aged from 19 to 43 years （average, 28.3 ±3.2 years）. In group B, there were 24 patients. 18 men and 6 women, aged from 21 to 44 years （average, 29. 1±3.5 years） . The 2 groups were compared in terms of ffacture reduction, time for fracture union, visual analogue scale （VAS） of the knee at flexion of 90°, reduced circumference of the affected leg emnpared with the health leg, reduced range of motion （ROM） compared with the health leg, and Lyshohn scores of knee functional recovery. Results There were significant differences between group A and group B in terms of fracture reduction （88.9% vs. 79.2% ）, time for union （10.9 ± 1.3 weeks vs. 12.5 ± 1.5 weeks）, VAS scores at one week and one month postoperafion, reduced leg circumferences at 1, 3, 6, 12 months postoperation, reduced ROM of the knee at I and 3 months postoperation, and Lyshohn scores of the knee funcetion at 1 and 3 months postoperation （ P 〈 0.05）. There were no significaut differences between group A and group B in terms of VAS scores at 3 months postoperation and Lysholm scores of the knee function at 6 months postoperation （ P 〉 0. 05） . Conclusion Compared with open reduction and internal fixation, minimally invasive surgery with a percutaneous tension baud may have ad- vantages of sumll scar, better fracture reduction with the help of arthroscnpy, faster union of fracture and earlier recovery of knee function in the treatment of transverse patellar fractures with displacement less than 3 em.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2012年第11期940-944,共5页
Chinese Journal of Orthopaedic Trauma
关键词
髌骨
骨折
骨折阎定术
内
外科手术
微创性
Patellar
Fractures, bone
Fracture fixation, internal
Surgical procedures, mini- really invasive
