线缆固定技术治疗老年髌骨下极骨折

发布时间：2019-04-24 18:45

【摘要】：[目的]探讨运用爱惜邦行髌韧带编织固定,结合钛缆捆扎技术治疗老年骨质疏松性髌骨下极骨折的临床疗效。[方法]回顾性分析2014年1月~2015年9月本院收治入院的42例老年髌骨下极骨折患者资料,男18例,女24例,年龄59~72岁,闭合骨折38例,开放骨折4例(均为Gustilo I型骨折)。受伤至手术时间平均为2.8 d(8 h~5 d)。术中先采用爱惜邦对髌韧带编织缝合后复位骨折,经骨隧道固定于髌骨上极,再结合钛缆环扎固定,必要时加用张力带固定。术后随访观察骨折愈合时间及膝关节功能,采用Bostman髌骨骨折功能评分标准评定患肢功能。[结果]术后患者随访8~28个月(平均18个月),骨折愈合时间9~12周,无伸膝无力、无内固定移位及断裂者。术后8个月按照Bostman髌骨骨折功能评分:平均28.9分,其中优33例,良9例,优良率100%。膝关节稳定性良好,末次随访膝关节平均活动度:伸直-1°,屈曲127°。所有患者股四头肌力5级,行走恢复至术前状态。[结论]线缆固定技术可有效的治疗老年髌骨下极骨折,固定牢固可靠,特别适用于髌骨下极骨块较小、骨质疏松的患者,有利于术后早期进行膝关节功能锻炼,避免关节僵硬,是治疗老年髌骨下极骨折一个简便可行的方法。
[Abstract]:[objective] to explore the clinical effect of patellar ligament braiding fixation combined with titanium cable binding technique in the treatment of senile osteoporotic fracture of the inferior pole of patella. [methods] from January 2014 to September 2015, 42 elderly patients with fracture of the inferior pole of patella were analyzed retrospectively. There were 18 males and 24 females, aged 59 to 72 years old, 38 cases of closed fractures and 4 cases of open fractures (all of them were Gustilo I fractures). The average time from injury to operation was 2.8 days (8 hours to 5 d). During the operation, the patellar ligament was stitched and then the fracture was reattached. The fracture was fixed through the bone tunnel to the superior pole of the patella, and then fixed with the titanium cable. If necessary, the tension band was used to fix the fracture. The time of fracture healing and the function of knee joint were observed after operation. The function of the affected limb was evaluated by Bostman patellar fracture function scoring standard. [results] the patients were followed up for 8 months and 28 months (mean 18 months). The fracture healing time was 9 to 12 weeks. There was no weakness of knee extension, no internal fixation displacement and fracture. According to the Bostman patellar fracture function score at 8 months after operation, the average score was 28.9, in which 33 cases were excellent, 9 cases were good, and the excellent and good rate was 100%. The stability of knee joint was good. The mean range of motion in the last follow-up was-1 掳and 127 掳respectively. All patients with quadriceps femoris muscle strength level 5, walking restored to preoperative state. [conclusion] the technique of cable fixation can effectively treat the fracture of the inferior pole of the patella in the elderly, and the fixation is firm and reliable. It is especially suitable for the patients with small bone mass of the inferior pole of the patella and osteoporosis, which is beneficial to the early functional exercise of the knee after operation. To avoid joint stiffness is a simple and feasible method to treat the fracture of the inferior pole of patella in the elderly.
【作者单位】：东南大学附属中大医院创伤骨科;
【基金】：国家自然科学基金资助项目(编号:81572188)
【分类号】：R687.3

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