三种不同的内固定方式治疗髌骨横行骨折回顾性比较

发布时间：2018-02-03 18:23

本文关键词： 髌骨骨折空心加压螺钉克氏针张力带　出处：《吉林大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：探讨三种不同的内固定方式治疗髌骨横行骨折的临床疗效，并对术前、术中及术后各项指标进行统计学分析，为髌骨横行骨折手术内固定方式选择提供临床依据。方法：回顾性分析我院收治的年龄在21-79岁之间109例患者（男性56名，女性53名），病人被分为3组，，A组克氏针“8”字张力带钢丝组（37例患者，26-79岁，平均年龄56.12岁）；B组单纯应用空心加压螺钉组（35例患者，22-76岁，平均年龄54.3岁）；C组空心加压螺钉“8”字张力带钢丝组（37例患者，21-75岁，平均年龄56.12岁）。术后随访1-2年，对三组患者在术前、术中及术后相关指标进行回顾性评估分析，分析比较三组之间手术时间、并发症、术后骨折端间距、骨折的愈合时间和膝关节lowa评分之间的区别。结果：在克氏针“8”字张力带钢丝组有9例患者出现皮肤刺激征，7例患者出现钢丝的松动，其中有3例患者需要二次手术，其余两组未出现并发症，术后骨折端之间的间距比其他两组都要大。单纯应用空心加压螺钉组及空心加压螺钉“8”字张力带钢丝组，术后两组骨折端之间的间距无较大差距。单纯应用空心加压螺钉组手术时间最短。三组之间骨折的愈合时间及膝关节lowa评分无明显差距。结论：三种内固定方式均适用于髌骨横行骨折，依据各自的优缺点及临床数据分析，我们认为空心加压螺钉“8”字张力带钢丝具有更显著的优越性，可做为临床治疗髌骨横行骨折时首选内固定方式。
[Abstract]:Objective: To explore the clinical effect of three different internal fixation methods in the treatment of transverse patellar fracture and to analyze the indexes before, during and after operation statistically. To provide clinical basis for the choice of internal fixation for patellar transverse fracture. Methods: A retrospective analysis of 109 patients (56 males and 53 females) aged between 21 and 79 years in our hospital was conducted. The patients were divided into 3 groups. In group A, 37 patients were 26 to 79 years old, with an average age of 56.12 years. In group B, 35 patients were treated with hollow compression screw alone, aged 22 to 76 years, with an average age of 54.3 years. In group C, 37 patients (mean age 56.12 years) with hollow compression screw "8" tension band steel wire group were treated with 21 to 75 years of age and followed up for 1-2 years before operation. The operative time, complications, fracture end spacing, fracture healing time and lowa score of knee joint were analyzed and analyzed retrospectively. Results: There were 9 cases of skin irritation sign and 7 cases of loosening of steel wire in the "8" tension band steel wire group of Kirschner needle, among which 3 cases needed secondary operation, and the other two groups had no complications. The distance between the fracture ends after operation was larger than that between the other two groups. The hollow compression screw group and the hollow compression screw "8" tension band steel wire group were used only. There was no significant difference between the two groups in the distance between the fracture ends after operation. The operation time was the shortest in the single hollow compression screw group, but there was no significant difference in the fracture healing time and the knee joint lowa score between the three groups. Conclusion: The three internal fixation methods are suitable for transverse patellar fracture. According to their advantages and disadvantages and clinical data analysis, we believe that the hollow compression screw "8" tension band wire has more significant advantages. It can be used as the first choice of internal fixation in the treatment of transverse patella fracture.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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