摘要
目的探讨空心螺钉＋独立垂直钢丝环扎固定治疗急性髌骨下极骨折的可行性及临床疗效。方法2012年5月-2013年9月，采用空心螺钉＋独立垂直钢丝环扎治疗14例急性单例髌骨下极新鲜闭合骨折。致伤原因：交通伤8例，摔伤6例。骨折按AO分型：34A1型8例，34A2型6例。受伤至手术时间1～7d，平均2．5d。骨折切开复位后采用空心螺钉＋独立垂直钢丝环扎内固定，按照下极骨折粉碎程度选用钢丝环扎数量。术后影像学评估骨折愈合、内固定位置及髌骨长度等情况；临床采用患膝活动度及Bostman髌骨骨折功能评分评估疗效。结果14例均获12～29个月（平均15个月）随访。术后2周切口均愈合良好，X线片检查骨折对位对线良好，内固定位置无异常。术后6，12个月随访X线片显示骨折均骨性愈合，钢丝等内固定位置良好，髌骨长度无明显缩短；12个月时膝关节活动度屈（126．0±4．5）°、伸（2．0±1．7）°，Bostman髌骨骨折功能评分为（28．1±1．9）分，其中优12例，良2例，优良率为100％。结论空心螺钉＋独立垂直钢丝环扎治疗急性髌骨下极骨折能有效维持髌骨下极骨折块的复位固定，且疗效确切，是一种值得推荐的术式。
Objective To investigate the feasibility and clinical effect of cannulated screws plus separate vertical wirings technique for acute fracture of the inferior pole of the patella. Methods From May 2012 to September 2013, 14 patients with fresh closed unilateral fracture of the inferior pole of the patella were treated with the cannulated screws plus separate vertical wirings. Eight patients were injured in traffic collisions and 6 in fall accidents. Fracture AO classification was type 34A1 in 8 patients and type 34A2 in 6 patients. Time from injury to operation was 1-7 clays （mean, 2.5 days）. Number of tie wires was determined according to the degree of fracture comminution. Fracture healing, fixed position and patellar length were evaluated by radiographic examination postoperatively. Knee mobility and Bostman evaluation system were investigated to analyze the clinical effect. Results All the patients obtained average 15-month follow-up （range, 12 to 29 months）. At postoperative 2 months, the fracture healed with good alignment of the broken bone and proper place of the internal fixation device noted on the X-ray films. At postoperative 6 and 12 months, X-ray films revealed fracture bony healing, good location of the wire internal fixation, and no apparent shortening of the patella. At the 12 months, range of knee motion was （ 126.0 ± 4.5 ） o for flexion and （ 2.0 ± 1.7 ） ° for extension. Bostman functional score for patella fracture was （28. 1± 1.9）points. And 12 patients were rated as excellent and 2 good, with excellence rate of 100%. Conclusion Cannulated screw fixation plus separate vertical wiring is effective to stabilize patella inferior pole fracture and has good results, indicating a recommended surgical method.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2015年第8期704-708,共5页
Chinese Journal of Trauma
关键词
髌骨
骨折固定术
内
空心螺钉
Patella
fracture fixation, internal
Cannulated screws
