摘要
目的 总结近年髌骨下极骨折手术治疗方法及研究进展,为临床应用提供参考。方法 广泛查阅有关手术治疗髌骨下极骨折的文献,总结各手术方法研究进展、优势及局限性。结果 髌骨下极是伸膝装置重要组成部分,具有加强股四头肌力臂作用。该部位骨折相对少见,且多为粉碎性,通常需要手术治疗。目前治疗髌骨下极骨折手术方式较多,包括髌骨下极切除术、张力带技术、钢板内固定术、带线锚钉技术、镍钛聚髌器、独立垂直钢丝固定技术等,不同方式各具特点且各有优劣。研究表明,单一内固定方式并发症较多且容易发生内固定失败,因此目前研究以及临床应用以多种内固定方式相结合为主。结论 对于髌骨下极骨折,如骨折块体积较大且以横形分布为主时,宜选择以张力带技术为主的联合固定方式;骨折块粉碎严重、骨块体积较小时,基于缝合固定的综合内固定方式疗效更佳。
Objective To summarize the surgical treatment methods and progress of inferior patellar pole fractures and provide reference for clinical application. Methods The literature on surgical treatment of inferior patellar pole fractures was extensively reviewed, and the relevant research progress, advantages, and limitations were summarized.Results The inferior pole of the patella is an important part of the knee extension device, which can strengthen the force arm of the quadriceps. Inferior patellar pole fractures are relatively rare and often comminuted, usually requiring surgical treatment. At present, there are various methods to treat inferior patellar pole fractures, including patellectomy of inferior pole, tension-band wiring technique, plate internal fixation, suture anchor fixation, claw-like shape memory alloy, separate vertical wiring technique. Different methods have their own characteristics, advantages, and disadvantages. The single internal fixation method has more complications and is easy to cause fixation failure. Therefore, the trend of combining various internal fixation methods is developing at present. Conclusion When the main fragment of the inferior patellar pole fracture is large and mainly distributed transversely, the combination protocol based on tension-band wiring technique can be regarded as an ideal choice. When the fragments are severely damaged and small, the comprehensive protocol based on suture fixation can result in a better postoperative functional recovery.
作者
刘晨东
胡孙君
张世民
LIU Chendong;HU Sunjun;CHANG Shimin(Department of Orthopaedics,Yangpu Hospital,Tongji University School of Medicine,Shanghai,200090,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2023年第1期115-119,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
上海市卫生健康委员会面上项目(202140231)。
关键词
髌骨下极骨折
手术治疗
内固定
Inferior patellar pole fracture
surgical treatment
internal fixation
