[1]包杭生△ 冯宗权 邹勇根.3种不同内固定方式治疗C型髌骨骨折的疗效对比[J].中国中医骨伤科杂志,2019,27(03):15-19.
　BAO Hangsheng FENG Zongquan ZOU Yonggen.Comparison of Three Different Internal Fixation Methods in the Treatment of Patella Fractures of Type C[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(03):15-19.
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3种不同内固定方式治疗C型髌骨骨折的疗效对比()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年03期
页码:
15-19
栏目:
临床研究
出版日期:
2019-02-28

文章信息/Info

Title:
Comparison of Three Different Internal Fixation Methods in the Treatment of Patella Fractures of Type C
文章编号:
1005-0205(2019)03-0015-05
作者:
包杭生1△ 冯宗权1 邹勇根1
1广东省佛山市中医院(广东 佛山,528000)
Author(s):
BAO Hangsheng1△ FENG Zongquan1 ZOU Yonggen1
1Foshan Hospital of Traditional Chinese Medicine, Foshan 528000,Guangdong China.
关键词:
髌骨骨折;  克氏针;  空心钉;  髌骨爪
Keywords:
patella fractures;  Kirschner nail;  cannulated screw;  patella concentrator
分类号:
R683.42
文献标志码:
A
摘要:
目的:比较克氏针钢丝张力带内固定、空心钉钛缆张力带内固定与髌骨爪内固定这3种不同内固定方式治疗C型髌骨骨折的临床疗效。方法:回顾性分析2014年1月至2017年1月单侧新鲜闭合性C型髌骨骨折共99例患者,其中予克氏针钢丝张力带内固定(A组)35例,空心钉钛缆张力带内固定(B组)31例,髌骨爪内固定(C组)33例。男62例,女37例; 年龄16～84岁,平均年龄46.5岁。3组患者一般资料比较,差异均无统计学意义(P>0.05)。比较3组手术时间、骨折愈合时间,1年随访时膝关节主动屈曲最大活动度以及Bostman髌骨骨折临床疗效评分,同时记录感染、内固定失效、局部皮肤刺激、骨折再移位、创伤性关节炎等术后并发症。结果:3组患者均获随访,随访时间12～24个月,平均18.8个月。3组手术时间比较,差异无统计学意义(P>0.05)。骨折愈合时间比较,B组、C组分别较A组时间短,差异均有统计学意义(P<0.05),B组、C组差异无统计学意义(P>0.05); 1年随访时膝关节主动屈曲最大活动度与Bostman髌骨骨折临床疗效评分比较,B组较C组好,C组又较A组好,差异均有统计学意义(P<0.05)。结论:在骨折愈合方面,空心钉钛缆张力带内固定、髌骨爪优于克氏针钢丝张力带内固定; 在功能评价方面,空心钉钛缆张力带内固定优于克氏针钢丝张力带内固定、髌骨爪内固定。在严格掌握手术适应症及禁忌症的前提下,空心钉钛缆张力带内固定能够满足解剖复位、坚强固定、早期功能锻炼的要求,是治疗C型髌骨骨折较为理想的方法之一。
Abstract:
Objective:To compare the clinical efficacy of three different internal fixation methods(Kirschner nail wire tension-band, cannulated screw titanium cable tension-band and patella concentrator)for patella fractures of type C. Methods:From January 2014 to January 2017, the medical records of 99 patients with unilateral fresh closed patella fractures of type C were analyzed retrospectively, where in Kirschner nail wire tension-band internal fixation was used in 35 cases(group A), cannulated screw titanium cable tension-band internal fixation was used in 31 cases(group B), and patella concentrator internal fixation was used in 33 cases(group C). There were 62 males and 37 females, and ranged in age from 16 to 84 years with an average age of 46.5 years. There was no statistically significant difference among the 3 groups in terms of general information(P>0.05). The 3 groups were compared in terms of operation time, fracture healing time, maximum active flexions of the knee at the time of 1 year follow-up, and Bostman clinical efficacy score of patella fracture, and recorded postoperative complications, such as infection, internal fixation failure, local skin irritation, fragment re-displacement and traumatic arthritis. Results: Patients were followed up for 12 to 24 months with an average of 18.8 months. There was no statistically significant difference among the 3 groups in operation time(P>0.05). There were statistically significant differences in fracture healing time compared group B shorter than group A, and compared group C shorter than group A(P<0.05), and no statistically significant difference between group B and group C(P>0.05). In terms of maximum active flexions of the knee at the time of 1 year follow-up and Bostman clinical efficacy score of patella fracture, there were statistically significant differences compared group B better than group C, and compared group C better than group A(P<0.05). Conclusion:Cannulated screw titanium cable tension-band and patella concentrator are superior to Kirschner nail wire tension-band in terms of fracture healing; cannulated screw titanium cable tension-band is better than Kirschner nail wire tension-band and patella concentrator in terms of function evaluation. Therefore, on the premise of strictly mastered the operation indications and contraindications, cannulated screw titanium cable tension-band can better able to meet the requirements of anatomical reduction, strong fixation and early function exercise.It is currently one of the ideal methods for treatment of patella fracture of type C.

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备注/Memo

备注/Memo:
1广东省佛山市中医院(广东 佛山,528000)
△通信作者 E-mail:hsbao2006@126.com
更新日期/Last Update: 2019-02-28