纵向钢丝捆绑结合克氏针张力带治疗髌骨下极粉碎骨折

发布时间：2017-12-31 02:25

本文关键词：纵向钢丝捆绑结合克氏针张力带治疗髌骨下极粉碎骨折　出处：《北京大学学报(医学版)》2016年03期 　论文类型：期刊论文

【摘要】：目的:为达到稳定的骨折固定,牢固的骨性愈合,满足患者术后即刻开始功能康复的要求,使用纵向钢丝捆绑结合克氏针张力带的方法治疗未累及关节面的髌骨下极粉碎骨折,观察其并发症并评价疗效。方法:回顾性研究了2013年1月至2015年1月使用纵向钢丝捆绑结合克氏针张力带治疗的15例髌骨下极粉碎骨折,其中男11例,女4例,平均年龄(54.5±6.9)岁,平均伤后(4.5±1.4)d行手术治疗。对患者的一般情况、受伤机制、局部软组织情况、骨折的类型等进行记录和分析,患者行术前CT检查以判断和测量下极骨折块的形态和大小,术后对患者进行连续随访,定期拍摄X线片,观察并记录骨折愈合情况及相关并发症并在最终随访时进行功能评分。结果:随访时间为(13.1±2.1)个月,所有患者均恢复顺利,未出现感染、骨折不愈合、内固定物失效等并发症。患者膝关节平均活动范围为126.7°±6.9°,与对侧肢体相比,屈曲活动范围平均减少10.3°±8.8°。根据B錸stman评分系统评判,优良率达100%,平均(28.9±1.1)分。结论:对于未累及关节面的髌骨下极粉碎骨折,可首先通过纵向钢缆捆绑复位并且维持复位,同时结合克氏针张力带固定可提供非常可靠的骨性固定,操作简单、安全,能够满足术后即刻开始功能康复的要求,膝关节功能可得到很好的恢复,疗效满意。
[Abstract]:Objective: in order to achieve stable fracture fixation, solid bone healing, to meet the patients immediately after the functional rehabilitation requirements. Longitudinal wire binding combined with Kirschner wire tension band was used to treat the comminuted fracture of the inferior pole of patella without involvement of the articular surface. Methods: from January 2013 to January 2015, 15 cases of comminuted fracture of the inferior pole of patella were treated with longitudinal wire binding combined with Kirschner wire tension band. There were 11 males and 4 females with an average age of 54.5 卤6.9 years. The patients were treated with surgery on average 4.5 卤1.4 days after injury. The types of fractures were recorded and analyzed. The patients were examined by CT before operation to judge and measure the shape and size of the lower pole fractures. The patients were followed up continuously after operation and X-ray films were taken regularly. Results: the follow-up time was 13.1 卤2.1 months. All the patients recovered smoothly without infection. The average range of knee joint motion was 126.7 掳卤6.9 掳, compared with the contralateral limb. The range of flexion activity was reduced by 10. 3 掳卤8. 8 掳on average. The excellent and good rate was 100% according to the B rhenium stman scoring system. The average score was 28.9 卤1.1. Conclusion: for the comminuted fracture of the inferior pole of patella without involvement of the articular surface, the reduction can be first reduced by longitudinal cable binding and maintained. Combined with Kirschner wire tension band fixation can provide a very reliable bone fixation, simple operation, safety, can meet the requirements of immediate functional rehabilitation after surgery, knee function can be well recovered, the curative effect is satisfactory.
【作者单位】：北京积水潭医院创伤骨科;
【分类号】：R687.3
【正文快照】： 髌骨骨折是临床比较常见的骨折类型,髌骨下极的撕脱骨折并不多见,却可导致伸膝装置断裂,由于股四头肌收缩使骨折端移位非常明显,下极骨折块比较小且常伴有粉碎,即使手术治疗也很难稳定地固定骨折端、有效地重建伸膝装置,术后难以早期开始功能康复,可造成股四头肌肌力减退从而

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