手法复位经皮张力带固定治疗髌骨骨折的临床研究

发布时间：2018-06-21 00:31

本文选题：手法复位 + 经皮穿针　；参考：《福建中医药大学》2015年硕士论文

【摘要】：目的：通过对手法复位经皮张力带固定治疗髌骨骨折的临床研究,寻求一种创伤小、并发症少、操作简便、疗效可靠的治疗髌骨骨折的方法,以便在临床推广应用。方法：选取2013年3月至2014年6月山东省文登整骨医院创伤整复科收治的符合诊断及纳入标准的髌骨骨折患者共60例,采用随机排列法分为A(治疗组)、B(对照组)两组,每组30例,A组采用手法复位经皮张力带固定,B组采用切开复位张力带内固定,术后两组均给予石膏托或支具固定,应用抗生素1-3d,1周后去除外固定行膝关节屈伸功能训练,6-8周后视膝关节功能锻炼情况及拍片骨折愈合情况择期取出内固定。术后对所有病例进行定期随访,通过参照Bostman临床评分标准对膝关节功能进行评定,并对两组患者手术时间、住院时间、骨折临床愈合时间及膝关节活动度等进行统计分析。结果：所有患者随访3-6个月,平均5个月。术后对照组出现1例刀口浅表感染,后经治疗刀口愈合,其余未出现针眼或刀口感染、骨折不愈合、皮肤坏死、患处再受伤等情况,对两组患者的手术时间、住院时间、骨折临床愈合时间及膝关节活动度等进行统计分析发现除手术时间相当外,其余观察指标治疗组明显优于对照组(P0.05),通过参照Bostman临床评分标准对两组术后12周膝关节功能进行统计分析发现无统计学差异(P0.05)。结论：从各项统计资料来看,尽管治疗组与对照组手术时间及术后12周膝关节功能相当,但前者创伤更小,感染机会少,住院时间短,骨折愈合快,无需再次广泛切开取出内固定,且术后不留明显瘢痕,是一种较为理想的治疗方法,值得在临床推广应用。
[Abstract]:Objective: to explore a simple and effective method for the treatment of patellar fracture with manual reduction and percutaneous tension band fixation for the treatment of patellar fracture with less trauma, less complications, simple operation and reliable curative effect. Methods: from March 2013 to June 2014, 60 patients with patellar fracture who were admitted to Department of Trauma and Restoration, Wendeng whole Bone Hospital, Shandong Province, were randomly divided into two groups: group A (treatment group) and group B (control group). Each group (30 cases) was treated with manual reduction and percutaneous tension band fixation. Group B was treated with open reduction and tension band internal fixation. The knee joint flexion and extension function training was carried out after 1 week with antibiotics for 1 3 d and the internal fixation was taken out after 6 to 8 weeks of visual knee joint function exercise and fracture healing. All the patients were followed up regularly after operation. The knee joint function was evaluated by referring to Bostman's clinical score. The operation time, hospitalization time, fracture healing time and knee motion were statistically analyzed in the two groups. Results: all patients were followed up for 3-6 months with an average of 5 months. In the control group, one case appeared superficial infection of the knife edge after operation, and the other cases did not have needle eye or knife edge infection, fracture nonunion, skin necrosis, injury of the affected area, etc. The operation time and hospitalization time of the patients in the two groups were analyzed. The clinical healing time and knee motion of fracture were statistically analyzed. The other observation indexes in the treatment group were significantly better than that in the control group (P 0.05). The knee joint function of the two groups was statistically analyzed 12 weeks after operation according to the Bostman clinical score. No statistical difference was found between the two groups (P 0.05). Conclusion: according to the statistical data, although the operation time and function of knee joint in the treatment group and the control group are the same, the former has less trauma, less chance of infection, shorter hospital stay and faster fracture healing. It is an ideal method to remove internal fixation without extensive incision and no obvious scar after operation, which is worth popularizing in clinical practice.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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