单根钛缆环扎结合“8”字张力带治疗髌骨骨折疗效观察

发布时间：2018-10-11 12:42

【摘要】：目的探讨单根钛缆环扎结合"8"字张力带治疗髌骨骨折的临床疗效。方法 2012年6月—2014年11月,收治46例髌骨骨折患者。男30例,女16例;年龄20~86岁,平均54岁。骨折原因:摔伤27例,交通事故伤16例,击打伤3例。闭合性损伤41例,开放性损伤5例。左侧24例,右侧22例。骨折AO分型:34-A型3例,34-B型1例,34-C1型7例,34-C2型13例,34-C3型22例。受伤至手术时间为1~12 d,平均3.7 d。采用单根钛缆环扎加"8"字张力带内固定,在髌骨表面形成几何学"球冠"形状的张力带结构。结果术后患者切口均Ⅰ期愈合。患者均获随访,随访时间6~24个月,平均20.6个月。术后1例出现软组织刺激,2例出现1枚克氏针移位、钛缆部分松动。术后3个月复查X线示骨折均已愈合,期间无钛缆断裂发生;38例术后12个月时取出内固定物。术后12个月,按B?stman髌骨骨折疗效评分标准评价为24~30分,平均28.34分;优42例、良4例,优良率100%。结论单根钛缆环扎结合"8"字张力带治疗髌骨骨折具有固定牢固、并发症少的优点,术后允许早期进行膝关节功能锻炼,临床疗效满意。
[Abstract]:Objective to investigate the clinical effect of single titanium cable ring ligation combined with 8 character tension band in the treatment of patellar fracture. Methods from June 2012 to November 2014, 46 patients with patellar fracture were treated. There were 30 males and 16 females, aged 20 to 86 years (mean 54 years). Fracture causes: fall in 27 cases, traffic accident in 16 cases, hit injury in 3 cases. There were 41 cases of closed injury and 5 cases of open injury. Left 24 cases, right 22 cases. AO classification: 34-A type in 3 cases, 34-B in 1 case, 34-C1 type in 7 cases, 34-C2 type in 13 cases, 34-C3 type in 22 cases. The time from injury to operation was 1 and 12 days, with an average of 3.7 days. A single titanium cable ring with "8" tension band was used to form a geometric "ball crown" tension band structure on the surface of the patella. Results all the incisions healed in one stage after operation. All patients were followed up for 6 ~ 24 months (mean 20.6 months). Soft tissue stimulation was found in 1 case, displacement of Kirschner needle in 2 cases and partial loosening of titanium cable. X-ray examination 3 months after operation showed that the fracture had healed, and there was no rupture of titanium cable during the period, and 38 cases had taken out the internal fixation at 12 months after operation. 12 months after operation, 24 ~ 30 points (mean 28.34 points) were evaluated according to B?stman patellar fracture score, 42 cases were excellent, 4 cases were good, the excellent and good rate was 100%. Conclusion the treatment of patellar fracture with single titanium cable ring ligation combined with "8" tension band has the advantages of firm fixation and less complications. Early functional exercise of knee joint is allowed after operation, and the clinical effect is satisfactory.
【作者单位】：福建医科大学附属第一医院创伤骨科福建省创伤医学中心;
【基金】：福建省临床重点专科(西医类别)建设项目(闽卫科教[2012]149号) 福建省自然科学基金青年科技人才创新项目(2016J05183) 福建省中青年教师教育科技项目(JA14142)~~
【分类号】：R687.3

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