| 软组织带线铆钉治疗大块髌骨软骨骨折的临床观察 |
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投稿时间：2017-06-16
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| 期刊信息：《中国骨伤》2018年，第31卷，第12期，第1140-1143页 |
| DOI：10.3969/j.issn.1003-0034.2018.12.013 |
| 基金项目:河南省基础与前沿技术研究计划项目（编号：162300410093）；河南省医学科技攻关项目（编号：201602196） |
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中文摘要:
目的：观察软组织带线铆钉治疗大块髌骨软骨骨折的临床疗效。
方法：回顾性分析2015年6月至2017年2月收治的25例（25膝）大块髌骨软骨骨折的患者，其中男19例，女6例；左膝11例，右膝14例；车祸伤2例，运动时扭伤23例；年龄（25.12±6.02）岁；体重（62.48±7.91） kg；体重指数（23.25±1.51） kg/m2；发病至入院时间（1.96±1.51） d。临床表现为膝关节肿胀，浮髌试验阳性，疼痛剧烈，偶有关节绞索、屈伸活动受限，髌骨外侧缘压痛明显，髌骨外推试验阳性，外推恐惧试验阳性。术前均行X线及CT检查，X线示髌骨骨质连续性存在，关节腔内有一游离体。CT加三维重建显示髌骨软骨面骨缺损。25例均采用软组织带线铆钉固定游离的骨块。临床疗效观察包括手术前后膝关节Lysholm评分及术后Insall疗效评价。
结果：术后所有患者获随访，时间3~15（9.72±4.07）个月。术前Lysholm评分60.32±5.08，末次随访88.24±4.37，术后评分优于术前（t=-22.926，P<0.05）。根据Insall标准评价，优21例，良4例，未出现骨折块分离及患膝关节粘连。术后6周X线及CT显示骨折块位置良好，软骨面平滑无明显台阶，髌骨形态良好。术后6个月MRI显示髌骨软骨关节面平整。
结论：软组织带线铆钉治疗大块髌骨软骨骨折具有操作简单、术后恢复较快、无须二次手术、并发症较少、疗效确切等优点，值得临床推广。 |
| 【关键词】髌骨 骨折 骨折固定术,内 |
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| Clinical observation of soft tissue wire rivets in the treatment of large patellar cartilage fracture |
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ABSTRACT
Objective: To explore the clinical curative effect of soft tissue wire rivet for the treatment of fracture of patella cartilage.
Methods: A retrospective study was conducted in 25 patients(25 knees) from June 2015 to February 2017 in patients with patellar cartilage fractures. Among them,19 were male,6 were female,11 were left knee,14 were right knee. The accident occurred in 2 cases,23 cases of sprained athletes;the average age was(25.12±6.02) years old,the average weight was (62.48±7.91) kg,and the average body mass index was(23.25±1.51) kg/m2. The average time from injury to admission was (1.96±1.51) d. The clinical manifestations were swelling of knee joint,positive floating patella sign,severe pain,occasional joint strangulation,limited flexion and extension,obvious tenderness of lateral patella,positive patellar extrapolation test and positive extrapolation fear test. X-ray and CT examination were performed before operation. X-ray showed the continuity of patellar bone and a loose body in the joint cavity. CT and 3D reconstruction showed patellar cartilage and facial defects. All 25 patients were fixed with soft tissue wire rivet. The clinical efficacy included preoperative Lysholm score and Insall evaluation.
Results: All the patients were followed up,and the duration ranged from 3 to 15 months,with an average of(9.72±4.07) months. The preoperative Lysholm score was 60.32±5.08,and the final follow-up was 88.24±4.37. The postoperative score was better than that before operation(t=-22.926,P<0.05). According to Insall criteria,21 cases were excellent,4 cases were good,no fracture fragments were found and knee joint adhesion was found. Six weeks after operation,X-ray and CT showed that the fracture was well positioned,the cartilage surface was smooth without obvious steps,and the patella was in good shape. MRI showed the smooth articular surface of patellar cartilage at the 6th month after operation.
Conclusion: Soft tissue wire rivet for the treatment of massive patellar cartilage fracture has the advantages of simple operation,rapid postoperative recovery,no need for secondary operation pain,fewer complications,and definite effect,which is worthy of clinical promotion. |
| KEY WORDS Patella Fractures Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐向峰,刘鹏鹤,岳龙,康乐,代志鹏.软组织带线铆钉治疗大块髌骨软骨骨折的临床观察[J].中国骨伤,2018,31(12):1140~1143 |
| 英文格式: | XU Xiang-feng,LIU Peng-he,YUE Long,KANG Le,DAI Zhi-peng.Clinical observation of soft tissue wire rivets in the treatment of large patellar cartilage fracture[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(12):1140~1143 |
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