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两种内固定方法治疗髌骨下极粉碎性骨折的病例对照研究
Hits: 2140   Download times: 642   Received:June 19, 2020    
作者Author单位UnitE-Mail
王攀峰 WANG Pan-feng 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China  
章云童 ZHANG Yun-tong 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China  
夏琰 XIA Yan 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China  
周潘宇 ZHOU Pan-yu 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China  
汪洋 WANG Yang 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China  
张洪跃 ZHANG Hong-yue 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China  
王宏瑞 WANG Hong-rui 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China  
付青格 FU Qing-ge 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China  
许硕贵 XU Shuo-gui 上海长海医院急诊科, 上海 200433 Department of Emergency, Changhai Hospital, Shanghai, 200433, China 791732715@qq.com 
期刊信息:《中国骨伤》2021年34卷,第10期,第920-924页
DOI:10.12200/j.issn.1003-0034.2021.10.007


目的:对比研究张力带联合髌骨环扎、记忆合金聚髌器固定两种方法治疗髌骨下极粉碎性骨折疗效。

方法:2015年7月至2019年7月收治60例髌骨下极骨折患者,根据手术方式的不同分为两组,A组30例采用记忆合金聚髌器(NiTi-PC)固定,男17例,女13例,年龄20~71(39.4±9.9)岁,其中摔伤19例,交通伤9例,运动伤2例,受伤至手术时间10~75(33.1±7.8)h;B组30例采用张力带加环扎固定,男15例,女15例,年龄21~76(38.6±10.2)岁,其中摔伤17例,交通伤12例,砸伤1例,受伤至手术时间10~91(34.5±9.1)h。观察对比两组患者的疗效。

结果:60例患者均获随访,随访时间9~30个月。两组术中出血量、手术时间、随访时间及骨折愈合时间比较差异无统计学意义。术后6个月按照膝关节Bostman功能评分:A组30例(28.6±4.7)分,其中优26例,良4例;B组30例(25.5±4.4)分,其中优20例,良8例,差2例;两组Bostman总评分和疗效评价结果比较差异均有统计学意义(P<0.05),A组评分明显优于B组。B组有1例出现克氏针退针,2例关节僵硬,3例出现内固定激惹。

结论:记忆合金聚髌器治疗髌骨下极骨折内固定坚强可靠,术后能早期行康复功能锻炼,关节功能及活动度恢复好,并发症少。
[关键词]:髌骨  骨折  骨折固定术,内  病例对照研究
 
A case-control study of two internal fixation methods in the treatment of comminuted fracture of inferior pole of patella
Abstract:

Objective: To compare the effects of tension band combined with patellar cerclage and memory alloy patellar concentrator fixation in the treatment of comminuted fracture of the lower pole of patella.

Methods: From July 2015 to July 2019,60 patients with distal patellar fracture were treated and were divided into two groups according to different operation methods. In group A,30 patients were fixed with memory alloy patellar concentrator (NiTi PC),17 males and 13 females,aged 20 to 71 (39.4±9.9) years,including 19 cases of falling injury,9 cases of traffic injury and 2 cases of sports injury. The time from injury to operation was 10 to 75 (33.1±7.8) hours; 30 cases in group B were fixed with tension band and cerclage,15 males and 15 females,aged 21 to 76 (38.6±10.2) years,including 17 cases of falling injury,12 cases of traffic injury and 1 case of smashing injury. The time from injury to operation was 10 to 91 (34.5±9.1) hours. The curative effects of two groups were observed and compared.

Results: All 60 patients were followed up for 9 to 30 months. There was no significant difference in intraoperative bleeding,operation time,follow-up time and fracture healing time between the two groups. Six months after operation,according to the Bostman function score of knee joint:30 cases in group A,the total score was 28.6±4.7,of which 26 cases were excellent and 4 cases were good. The total score of 30 cases in group B was 25.5±4.4,of which 20 cases were excellent,8 cases were good and 2 cases were poor. There were significant differences in Bostman total score and curative effect evaluation between two groups(P<0.05). The score of group A was significantly better than that of group B. In group B,1 case had Kirschner wire withdrawal,2 cases had joint stiffness and 3 cases had internal fixation irritation.

Conclusion: Memory alloy patellar concentrator is strong and reliable in the treatment of inferior patellar fracture. It can take early rehabilitation exercise after operation,with good recovery of joint function and range of motion and less complications.
KEYWORDS:Patella  Fractures  Fracture fixation,internal  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:王攀峰,章云童,夏琰,周潘宇,汪洋,张洪跃,王宏瑞,付青格,许硕贵.两种内固定方法治疗髌骨下极粉碎性骨折的病例对照研究[J].中国骨伤,2021,34(10):920~924
英文格式:WANG Pan-feng,ZHANG Yun-tong,XIA Yan,ZHOU Pan-yu,WANG Yang,ZHANG Hong-yue,WANG Hong-rui,FU Qing-ge,XU Shuo-gui.A case-control study of two internal fixation methods in the treatment of comminuted fracture of inferior pole of patella[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(10):920~924
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