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穿骨道线缆结合带尾孔克氏针治疗髌骨骨折
Hits: 1977   Download times: 440   Received:September 09, 2014    
作者Author单位UnitE-Mail
孙晓良 SUN Xiao-liang 温州医科大学附属第三医院骨科, 浙江 瑞安 325200 Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Rui'an 325200, Zhejiang, China  
杨国敬 YANG Guo-jing 温州医科大学附属第三医院骨科, 浙江 瑞安 325200 Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Rui'an 325200, Zhejiang, China jointsunxl@hotmail.com 
张雷 ZHANG Lei 温州医科大学附属第三医院骨科, 浙江 瑞安 325200 Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Rui'an 325200, Zhejiang, China  
王伟良 WANG Wei-liang 温州医科大学附属第三医院骨科, 浙江 瑞安 325200 Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Rui'an 325200, Zhejiang, China  
谢秉局 XIE Bing-ju 温州医科大学附属第三医院骨科, 浙江 瑞安 325200 Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Rui'an 325200, Zhejiang, China  
期刊信息:《中国骨伤》2015年28卷,第7期,第603-605页
DOI:10.3969/j.issn.1003-0034.2015.07.005


目的:探讨应用穿骨道线缆结合带尾孔克氏针治疗髌骨骨折的临床疗效。

方法:自2012年5月至2013年7月,采用穿骨道线缆结合带尾孔克氏针内固定治疗34例髌骨骨折患者,均为闭合性骨折,其中男18例,女16例;年龄26~81岁,平均(46.0±3.0)岁;横形骨折12例,粉碎性骨折22例。观察患者的手术时间、术中出血量、术后膝关节首次锻炼时间及术后并发症情况,术后根据Böstman髌骨骨折疗效评分标准对其功能进行评价。

结果:所有患者获得随访,时间12~26个月,平均(16.0±2.0)个月。所有患者伤口甲级愈合,骨折全部愈合。手术时间(54.2±10.4) min,术中出血量(56.0±8.5) ml,术后膝关节首次锻炼时间(4.6±1.3) d.术后无感染、退针、线缆松脱,无皮肤刺激等并发症发生。根据Böstman髌骨骨折疗效评分标准进行评价,总分29.06±1.67,其中优33例,良1例。

结论:穿骨道线缆结合带尾孔克氏针系统内固定治疗髌骨骨折,特别是横形骨折,固定牢固可靠,可早期活动膝关节,并发症少。
[关键词]:髌骨  骨折  线缆  骨折固定术,内
 
Treatment of patellar fractures with cable through the bone and Kirschner with a hole in the tail
Abstract:

Objective: To study clinical effects of a new internal fixation by using a cable through the bone and Kirschner with a hole in the tail,for the treatment of patellar fractures.

Methods: From May 2012 to July 2013,thirty-four patients with patellar fractures were treated with cable through the bone and Kirschner with a hole in the tail. All the patients had close fracture,including 12 transverse fractures and 22 comminuted fractures. There were 18 males and 16 females,ranging in age from 26 to 81 years old,with an average of(46.0±3.0) years old. After open reduction,two appropriate length of Kirschner with a hole in the tail were driven into the patella as perpendicular to the fracture line or the major fragments as possible. A transverse bone tunnel was then drilled with a Kirschner at one side of the patella. Then the cable,which was successively pulled through the bone tunnel and the hole of Kirschner,was crossed in a figure-eight over the anterior of the patella,tightened and fixated by special instruments. The Kirschner was clipped off on the edge of the hole. If it was a comminuted fracture,another cable was used to fasten the patella with cerclage. Postoperative evaluation was based on Bostman.

Results: All the patients were followed up,and the duration ranged from 12 to 26 months,with a mean of(16.0±2.0) months. Fractures healed in all the cases without such complications as infection,loosening of Kirschner and cable loop,and skin irritation. According to the Böstman score system,33 cases got an excellent result,and 1 good.

Conclusion: The cable through the bone and Kirschner with a hole in the tail is a simple,stable and effective method for the treatment of patellar fractures,especially the transverse fractures,with earlier knee exercise and fewer complications.
KEYWORDS:Patella  Fractures  Cable  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:孙晓良,杨国敬,张雷,王伟良,谢秉局.穿骨道线缆结合带尾孔克氏针治疗髌骨骨折[J].中国骨伤,2015,28(7):603~605
英文格式:SUN Xiao-liang,YANG Guo-jing,ZHANG Lei,WANG Wei-liang,XIE Bing-ju.Treatment of patellar fractures with cable through the bone and Kirschner with a hole in the tail[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(7):603~605
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