摘要
目的 通过对关节镜下复位经皮中空拉力螺钉联合金属缆索内固定治疗髌骨横行、纵形或上下嵴大块骨折的临床及生物力学研究,来评定它们的疗效。方法 回顾性分析从2011年10月至2013年1月共收治41例髌骨横行、纵形或上下嵴大块骨折的病人,分两组。A组20例使用关节镜下复位经皮中空拉力螺钉联合金属缆索内固定治疗;B组21例使用AO张力带钢丝治疗。对AB两组从出血量、手术时间、住院时间、骨性愈合时间、膝关节功能、固定牢固程度方面来进行比较分析两种不同固定方式的疗效。结果 经过6~18个月随访,A组优19例,良1例,优良率达100%。B组优18例,良2例,可1例,优良率达95.2%。在出血量、住院时间、固定牢固程度方面,关节镜下复位经皮中空拉力螺钉联合金属缆索治疗组优于AO张力带钢丝治疗组。结论 关节镜下复位经皮中空拉力螺钉联合金属缆索内固定和AO张力带钢丝内固定治疗髌骨横行、纵形或上下嵴大块骨折均能取得良好的疗效。采用关节镜下复位经皮中空拉力螺钉联合金属缆索内固定手术治疗具有损伤小,手术出血量少,住院时间短,固定牢靠,无明显并发症优点,可为髌骨横行、纵形或上下嵴大块骨折的理想选择。
Objective To assess the curative effect of internal fixation treatment of patella joint metal cable transverse,longitudinal form or fluctuation crest large fracture by under arthroscopic reduction and percutaneous hollow tension screw. Methods From October 2011 to January 2013 of, 41 cases with patetlar transverse, longitudinal or upper and lower bone fracture were retrospective studied, and were divided into two groups. 20 cases in group A were treated with arthroscopic reduction and percutaneous hollow pulling screws combined with metal cable internal fixation.21 cases in group A were treated with AO tension band wire. The effects of two the groups were compared, including： bleeding volume, operation time, hospitalization time, bone healing time, knee joint function and fixed firm degree. Results After 6 to 18 months follow-up.In group A, 19 cases was excellent,1 case good, the excellent and good rate was 100%. In group B, 18 cases was excellent, 2 cases good, the excellent rate was 95.2%. The amount of bleeding, length of stay, and fixed firm degree, the group A were superior to those in the group B. Conclusion The two methods can could all achieved well clinical effects. The treatment of under arthroscopic reduction and percutaneous cannulated screws and metal cable internal fixation had the advantages of less injuryl, haemorrhage, short hospitalization time, firm fixation, and less obvious complications , and could be the ideal choice for the patellar transverse and longitudinal or ridge bulk fracture.
出处
《浙江创伤外科》
2016年第5期823-827,共5页
Zhejiang Journal of Traumatic Surgery
关键词
关节镜
螺钉
缆索
髌骨
骨折
Arthroscopy
Screw
The cables
Patella
Fracture
