目的研究双头加压螺钉及微型锁定接骨板在桡骨小头骨折内固定中的应用效果。方法选取2014年10月至2018年9月在安康市汉滨区第一医院骨科医院进行诊治的48例根据Mason分型判定为Ⅲ型的桡骨小头骨折患者,按照随机数表法将其分为观察组和...目的研究双头加压螺钉及微型锁定接骨板在桡骨小头骨折内固定中的应用效果。方法选取2014年10月至2018年9月在安康市汉滨区第一医院骨科医院进行诊治的48例根据Mason分型判定为Ⅲ型的桡骨小头骨折患者,按照随机数表法将其分为观察组和对照组,每组24例。观察组患者采用双头加压螺钉进行内固定,对照组患者采用微型锁定接骨板进行内固定。于术后6个月,比较两组患者的改良式Broberg and Morrey评分、桡肘关节活动度及并发症发生情况,同时进行影像学检查,观察骨骼愈合情况。结果48例患者完成研究,从愈合情况上看所有患者的骨折线均已愈合,无法从阅片中观测到明显的骨折线;观察组患者的手术时间和住院时间分别为(76.80±10.98)min、(14.28±0.85)d,分别与对照组的(78.16±9.87)min、(14.61±1.16)d比较差异均无统计学意义(P>0.05);观察组患者的Broberg and Morrey评分为(88.79±4.27)分,明显高于对照组的(81.60±5.75)分,差异具有统计学意义(P<0.05);观察组患者的肘关节屈曲角度、前臂旋前角度、前臂旋后角度分别为(131.26±0.87)°、(83.21±2.90)°和(84.92±2.33)°,均明显高于对照组的(118.63±5.27)°、(75.12±3.81)°和(74.31±2.67)°,差异均有显著统计学意义(P<0.01);观察组患者的并发症发生率为8.33%,明显低于对照组的33.33%,差异有统计学意义(P<0.05)。结论双头加压螺钉技术在桡骨小头骨折的内固定治疗中有着很好的应用价值,其固定效果良好,能有效改善患者桡关节基本功能和稳定性的恢复,且并发症发生较少,是目前较为安全可靠的内固定手术方案。展开更多
Purpose:This study was designed to compare the clinical efficacy of"8"and"0"wire fixation systems combined with double-head cannulated compression screws or Kirschner wires for the treatment of tra...Purpose:This study was designed to compare the clinical efficacy of"8"and"0"wire fixation systems combined with double-head cannulated compression screws or Kirschner wires for the treatment of transverse patellar fractures.Methods:From September 2011 to September 2018,patients with closed transverse patellar fractures treated with a double-head compression screw or Kirschner wire were included and analyzed retrospectively.Patients with patellar fractures combined with distal femoral fractures,tibial plateau fracture or preoperative lower limb dysfunction were excluded.The patients treated with the"8"tension band wire fixation system and Kirschner wire were taken as Group A;those treated with the"0"fixation system and Kirschner wire were taken as Group B;those treated with the"8"fixation system and double-head cannulated compression screw were taken as group C;and those treated with the"0"fixation system and double-head cannulated compression screw were taken as group D.Six weeks and one year after the operation and every month from the third month after the operation until the fractures healed,an X-ray examination was performed to identify fracture healing.The time of fracture healing and postoperative complications of the four groups were compared.One year after the operation,knee function was evaluated by Bostman’s score.Results:During the study period,168 patients with patellar fractures were treated by operations,and 88 patients were excluded because the fracture type did not meet the requirements or because there were combined fractures of the distal femur or tibial plateau.As a result,80 patients were included in this study,20 in each group.All the patients were followed up for an average period of 12.2 months.Compared with Group A,patients in Group D presented less postoperative discomfort in the prepatellar region,quicker fracture healing,less fixation failure and better postoperative knee function scores(all p<0.05).The incidence of internal fixation failure in Group(B+D)was lower than that in Group(A展开更多
文摘目的研究双头加压螺钉及微型锁定接骨板在桡骨小头骨折内固定中的应用效果。方法选取2014年10月至2018年9月在安康市汉滨区第一医院骨科医院进行诊治的48例根据Mason分型判定为Ⅲ型的桡骨小头骨折患者,按照随机数表法将其分为观察组和对照组,每组24例。观察组患者采用双头加压螺钉进行内固定,对照组患者采用微型锁定接骨板进行内固定。于术后6个月,比较两组患者的改良式Broberg and Morrey评分、桡肘关节活动度及并发症发生情况,同时进行影像学检查,观察骨骼愈合情况。结果48例患者完成研究,从愈合情况上看所有患者的骨折线均已愈合,无法从阅片中观测到明显的骨折线;观察组患者的手术时间和住院时间分别为(76.80±10.98)min、(14.28±0.85)d,分别与对照组的(78.16±9.87)min、(14.61±1.16)d比较差异均无统计学意义(P>0.05);观察组患者的Broberg and Morrey评分为(88.79±4.27)分,明显高于对照组的(81.60±5.75)分,差异具有统计学意义(P<0.05);观察组患者的肘关节屈曲角度、前臂旋前角度、前臂旋后角度分别为(131.26±0.87)°、(83.21±2.90)°和(84.92±2.33)°,均明显高于对照组的(118.63±5.27)°、(75.12±3.81)°和(74.31±2.67)°,差异均有显著统计学意义(P<0.01);观察组患者的并发症发生率为8.33%,明显低于对照组的33.33%,差异有统计学意义(P<0.05)。结论双头加压螺钉技术在桡骨小头骨折的内固定治疗中有着很好的应用价值,其固定效果良好,能有效改善患者桡关节基本功能和稳定性的恢复,且并发症发生较少,是目前较为安全可靠的内固定手术方案。
文摘Purpose:This study was designed to compare the clinical efficacy of"8"and"0"wire fixation systems combined with double-head cannulated compression screws or Kirschner wires for the treatment of transverse patellar fractures.Methods:From September 2011 to September 2018,patients with closed transverse patellar fractures treated with a double-head compression screw or Kirschner wire were included and analyzed retrospectively.Patients with patellar fractures combined with distal femoral fractures,tibial plateau fracture or preoperative lower limb dysfunction were excluded.The patients treated with the"8"tension band wire fixation system and Kirschner wire were taken as Group A;those treated with the"0"fixation system and Kirschner wire were taken as Group B;those treated with the"8"fixation system and double-head cannulated compression screw were taken as group C;and those treated with the"0"fixation system and double-head cannulated compression screw were taken as group D.Six weeks and one year after the operation and every month from the third month after the operation until the fractures healed,an X-ray examination was performed to identify fracture healing.The time of fracture healing and postoperative complications of the four groups were compared.One year after the operation,knee function was evaluated by Bostman’s score.Results:During the study period,168 patients with patellar fractures were treated by operations,and 88 patients were excluded because the fracture type did not meet the requirements or because there were combined fractures of the distal femur or tibial plateau.As a result,80 patients were included in this study,20 in each group.All the patients were followed up for an average period of 12.2 months.Compared with Group A,patients in Group D presented less postoperative discomfort in the prepatellar region,quicker fracture healing,less fixation failure and better postoperative knee function scores(all p<0.05).The incidence of internal fixation failure in Group(B+D)was lower than that in Group(A
