摘要
目的探讨微型钢板联合钢丝张力带固定治疗髌骨下极粉碎性骨折的疗效。方法采用回顾性队列研究分析2018年10月至2020年10月中国科学技术大学附属第一医院收治的50例髌骨下极粉碎性骨折(AO分型34-A1型)患者临床资料,其中男28例,女22例;年龄17~77岁[(51.4±11.5)岁]。23例采用微型钢板联合钢丝张力带固定治疗(A组),27例采用钢缆环扎联合钢丝张力带固定治疗(B组)。比较两组骨折愈合情况、骨折愈合时间、末次随访时膝关节活动度和Bostman评分。观察两组并发症(感染、内固定失败及激惹等)发生情况。结果患者均获随访12~18个月[(14.1±2.1)个月]。骨折均获骨性愈合,A组骨折愈合时间为(9.9±1.8)周,B组为(10.3±1.4)周(P>0.05);末次随访时A组膝关节活动度为(129.2±9.7)°,优于B组的(122.3±11.0)°(P<0.05)。末次随访时A组膝关节Bostman评分为(27.6±1.8)分,B组为(26.8±1.9)分(P>0.05)。A组术后未出现相关并发症,B组2例在骨折愈合后随访出现克氏针退钉张力带脱落,无明显不适,未予以特殊处理。结论对于髌骨下极粉碎性骨折,微型钢板联合钢丝张力带固定较钢缆环扎联合钢丝张力带固定具有更好的临床疗效,膝关节活动度更好,且无内固定失败等并发症,值得临床推广。
Objective To investigate the clinical effect of combined treatment of comminuted inferior pole patellar fracture with micro-plate and tension-band wire.Methods A retrospective cohort study was conducted in 50 patients with comminuted inferior pole patellar fracture(AO classification of type 34-A1)admitted to First Affiliated Hospital of University of Science and Technology of China from October 2018 to October 2020,including 28 males and 22 females,aged 17-77 years[(51.4±11.5)years].A total of 23 patients were treated with micro-plate combined with tension-band wire(Group A)and 27 patients were treated with cable wire looping combined with tension-band wire(Group B).Fracture union,union time and last follow-up evaluation of knee range of motion and Bostman score were compared between the two groups.Complications(infection,internal fixation failure,internal fixation irritation,etc.)were also observed.Results All patients were followed up for 12-18 months[(14.1±2.1)months].All patients had bone union,with no statistical difference between Group A[(9.9±1.8)weeks]and Group B[(10.3±1.4)weeks]in union time(P>0.05).Knee range of motion was(129.2±9.7)°in Group A at the last follow-up,better than(122.3±11.0)°in Group B(P<0.05).Knee Bostman score was(27.6±1.8)points in Group A,showing no statistical difference from that in Group B[(26.8±1.9)points](P>0.05).There were no postoperative complications in Group A.Two patients with tension band shedding of Kirschner wire after fracture healing were found in Group B,with no special treatment given due to no obvious discomfort.Conclusions For comminuted inferior pole patellar fracture,micro-plate combined with tension-band wire is more effective and provides better knee mobility with no complications of implant failure as compared with cable wire looping combined with tension-band wire.Therefore,the technique deserves clinical promotion.
作者
谢凯
杨家赵
朱万博
徐磊
徐玮
王叙进
方诗元
洪海鸥
Xie Kai;Yang Jiazhao;Zhu Wanbo;Xu Lei;Xu Wei;Wang Xujin;Fang Shiyuan;Hong Haiou(Department of Orthopedics,First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China;Department of Health Management Center,First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2022年第2期136-141,共6页
Chinese Journal of Trauma
关键词
膝关节
髌骨
骨折固定术
内
钢板
Knee joint
Patella
Fracture fixation,internal
Plate
