摘要
[目的]探讨关节镜辅助下复位经皮空心螺钉钢丝张力带内固定技术治疗粉碎性髌骨骨折的可行性。[方法]自2010年8月~2016年5月48例髌骨粉碎性骨折纳入本研究,其中27例采用关节镜辅助下复位后经皮空心螺钉钢丝张力带内固定治疗,21例采用传统切开复位内固定技术治疗。分别记录手术时间、切口长度、术中透视次数、骨折愈合时间、术后并发症。[结果]两组患者手术时间的差异无统计学意义(P=0.26);关节镜组的切口明显小于开放手术组,透视次数明显少于开放手术组,差异均有统计学意义(P<0.05)。两组患者均没有出现伤口感染、血管神经损伤等早期并发症。两组患者随访7~46个月,平均20个月。关节镜组的骨折愈合时间显著短于开放手术组(P<0.05);术后6个月Lysholm评分关节镜组优于开放手术组,差异有统计学意义(P<0.05);术后1年HSS评分关节镜组优于开放手术组,差异有统计学意义(P<0.05)。按胥少汀综合评定标准,关节镜组优良率100%,开放手术组优良率85.7%,两组差异有统计学意义(P<0.05)。两组患者均未发生骨折不愈合、内固定松动断裂等晚期并发症。[结论]关节镜辅助下经皮空心螺钉钢丝张力带内固定技术治疗粉碎性髌骨骨折具有关节面复位精准,切口小的优点,有利于早期康复与膝关节功能恢复。
[Objective] To evaluate technical feasibility and clinical outcome of the arthroscopy assisted reduction and per- cutaneous cannulated screw tension band internal fixation for the treatment of comminuted patellar fractures. [Method] From August 2010 to May 2016, 48 patients with eomminuted patellar fracture were included into this study. Of them, 27 patients had the comminuted patella fracture treated by a^reseopy assisted reduction and internal fixation with percutaneous cannulated screw tension band （the arthroscopy group）, while the other 21 patients underwent traditional open reduction and internal fixa- tion （the ORIF group） . The operation time, incision length, frequency of intraoperative fluoroscopy used, fracture healing time and postoperative complication were recorded, additionally, Lysholm score, HSS score and Xu＇s comprehensive grade were used for evaluation of the consequences. [Results] Although no a statistical difference was noted in operation time between the two groups （P〉0.05）, the arthroseopy group had significantly smaller incision and less frequency of fluoroscopy used than the ORIF group （P〈0.05） . No early complications, such as wound infection and neurovaseular injury occurred in any patient of both groups. All the patients in the two groups were followed up for 7 to 46 months with an average of 20 months. The arthroscopy group took considerably less time for bone healing than the ORIF group （P〈0.05）. In addition, the arthroscopy groups was statis- tically superior to the ORIF group in Lysholm score at 6 months and HSS score at 1 year after operation （P〈0.05）. In term of Xu＇ s scale, the results were graded as excellent and good in 100% patients of the arthroscopy group, whereas 85.7% patients of the ORIF group. No late complications, such as nonunion and implant loosening happened in any of them. [Conclusion] Arthrosco- py assisted reduction and percutaneous cannulated screw tension band internal fixation for the treatment of comminuted patellarfractu
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第24期2224-2228,共5页
Orthopedic Journal of China
关键词
髌骨骨折
关节镜
空心螺钉
内固定
patellar fracture, arthroscopy, cannulat-ed screw, internal fixation
