| 髌骨牵引配合手术治疗陈旧性髌骨骨折合并股四头肌挛缩 |
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Received:November 11, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 邢敦凯 |
XING Dun-kai |
十堰市太和医院骨关节科,湖北十堰442000 |
Department of Orthopaedics,Taihe Hospital,Shiyan 442000,Hubei,China |
chenwen1018@sohu.com |
| 党洪胜 |
DANG Hong-sheng |
十堰市太和医院骨关节科,湖北十堰442000 |
Department of Orthopaedics,Taihe Hospital,Shiyan 442000,Hubei,China |
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| 陈文 |
CHEN Wen |
十堰市太和医院骨关节科,湖北十堰442000 |
Department of Orthopaedics,Taihe Hospital,Shiyan 442000,Hubei,China |
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| 王平年 |
WANG Ping-nian |
十堰市太和医院骨关节科,湖北十堰442000 |
Department of Orthopaedics,Taihe Hospital,Shiyan 442000,Hubei,China |
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| 卢云 |
LU Yun |
十堰市太和医院骨关节科,湖北十堰442000 |
Department of Orthopaedics,Taihe Hospital,Shiyan 442000,Hubei,China |
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| 吴志勇 |
WU Zhi-yong |
十堰市太和医院骨关节科,湖北十堰442000 |
Department of Orthopaedics,Taihe Hospital,Shiyan 442000,Hubei,China |
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| 期刊信息：《中国骨伤》2006年19卷，第9期，第535-536页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨髌骨牵引配合手术治疗陈旧性髌骨骨折合并股四头肌挛缩的疗效。
方法:陈旧性髌骨骨折合并股四头肌挛缩患者13例,男9例,女4例;年龄20~46岁,平均37岁。受伤至手术时间6周~8个月,平均4个月。骨折分类:横形骨折8例,粉碎性骨折4例,髌骨下极骨折1例。骨折分离移位情况:<2cm者4例,2~3cm者7例,>3cm者2例。被动屈膝10°~20°者5例,21°~50°者7例,>50°者1例。用克氏针在骨折块的上1/3处行骨牵引,牵引过程中可同时配合CPM锻炼膝关节。1~2周后拍片证实两断端靠近后再行切开复位内固定术。
结果:13例均获得随访,随访时间8~36个月。根据王亦璁改良膝关节功能评分法,本组优8例,良4例,可1例。骨折均获得I期愈合,髌骨的解剖结构恢复,功能恢复良好。
结论:陈旧性髌骨骨折合并股四头肌挛缩骨折端分离,I期手术复位困难,而先行髌骨牵引后再行切开复位张力带固定,不但解决了股四头肌挛缩,有利于骨折的复位固定,而且保留了髌骨结构,保证了伸膝装置的完整性。 |
| [关键词]:牵引术 髌骨 骨折 外科手术 |
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| Patellar traction and surgical operation for treatment of old fracture of patella and quadriceps contracture |
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Abstract:
Objective:To discuss the method and effect of treatment of old fracture of patella and quadriceps contracture with patellar traction and operation.
Methods:Thirteen patients with old fracture of patella and quadriceps contracture included 9 male and 4 female with average age of 37 years ranging from 20 to 46 years. The average time of operation was 4 months after injuries (ranging from 6 weeks to 8 months).There were 8 patients with across fracture,4 with comminuted fracture and 1 with base fracture of patella.When straighten the knee joint,the separation distance of the fractured patella was less than 2 cm in 4 patients,ranged from 2 to 3 cm in 7 patients,exceeded 3 cm in 2 patients.The angle of passive genuflex was 10 to 19 degrees in 5 patients, 20 to 50 in 7 patients,more than 50 in 1 patient.All patients were treated with patellar traction in the 13 of the proximal fracture and train the knee joint with CPM at the same time.After the broken ends of fractured bone was close to each other,open reduction and internal fixation were done.
Results:Thirteen patients were followed-up from 8 to 36 monthes.According to WANG Yi-cong’s reformed graded method,in the 13 patients, 8 were excellent,4 were good,1 was fair.All patients were primarily healed,patella obtained anatomial reduction and functions of knee joint recovered satisfactorily.
Conclusion: Fracture separation is obviously in old ununited fractures of patella and quadriceps contracture and one stage reduction is difficulty.The technique of patellar traction and tension band fixation is a good method for the treatment of old ununited fracture of patella and quadriceps contracture.This methed is characterized by excellent functional and extension device of the knee recovery. |
| KEYWORDS:Traction Patella Fractures Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邢敦凯,党洪胜,陈文,王平年,卢云,吴志勇.髌骨牵引配合手术治疗陈旧性髌骨骨折合并股四头肌挛缩[J].中国骨伤,2006,19(9):535~536 |
| 英文格式: | XING Dun-kai,DANG Hong-sheng,CHEN Wen,WANG Ping-nian,LU Yun,WU Zhi-yong.Patellar traction and surgical operation for treatment of old fracture of patella and quadriceps contracture[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(9):535~536 |
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