针尾带孔自折式髌骨针联合张力带钢丝治疗髌骨粉碎性骨折的疗效及预后分析
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摘要
目的:研究针尾带孔自折式髌骨针联合张力带钢丝治疗髌骨粉碎性骨折的疗效及预后。方法:选取2014年6月~2016年6月接诊的80例髌骨粉碎性骨折患者进行研究。按照随机数表法,随机分为观察组和对照组。对照组采用张力带钢丝对患者进行治疗,观察组则采用针尾带孔自折式髌骨针联合张力带钢丝进行治疗。治疗后,分析比较两组患者的术中出血量、手术时间、骨折愈合时间及及住院时间,并对患者的关节屈曲度、Bostman评分及术后并发症进行调查分析。结果:观察组患者的术中出血量明显少于对照组,手术时间、骨折愈合时间及住院时间均明显短于对照组。观察组患者关节屈曲度明显大于对照组,Bostman评分明显高于对照组。观察组术后并发症发生率(3.33%)明显低于对照组(15.00%),两组比较有显著性差异。结论:针尾带孔自折式髌骨针联合张力带钢丝治疗髌骨粉碎性骨折疗效显著,安全性良好,值得广泛应用。
Objective To study the outcome and prognosis of comminuted patellar fracture treated with self retaining patellar needle and tension band steel wire. Methods 80 patients with patellar comminuted fracture from June 2014 to June 2016, were enrolled in this study. According to the random number table method, were randomly divided into observation group and control group. The control group was treated with tension band steel wire, while the observation group was treated with needle tail hole self folding patellar needle and tension band steel wire. After treatment, the intraoperative bleeding volume, operation time, fracture healing time and hospitalization time were compared between the two groups, and the joint flexion degree, Bostman score and postoperative complications were investigated and analyzed. Results The intraoperative blood loss in the observation group was significantly less than that in the control group, and the operation time, fracture healing time and length of stay were significantly shorter than those in the control group. The degree of joint flexion in the observation group was significantly higher than that in the control group, and the score of Bostman was significantly higher than that of the control group. The incidence of postoperative complications in the observation group(3.33%) was significantly lower than that in the control group(15%), and there was a significant difference between the two groups. Conclusion It is effective and safe to treat the comminuted patellar fracture with needle tail hole self folding patellar needle and tension band steel wire. It is worth to be widely applied.
Objective To study the outcome and prognosis of comminuted patellar fracture treated with self retaining patellar needle and tension band steel wire. Methods 80 patients with patellar comminuted fracture from June 2014 to June 2016, were enrolled in this study. According to the random number table method, were randomly divided into observation group and control group. The control group was treated with tension band steel wire, while the observation group was treated with needle tail hole self folding patellar needle and tension band steel wire. After treatment, the intraoperative bleeding volume, operation time, fracture healing time and hospitalization time were compared between the two groups, and the joint flexion degree, Bostman score and postoperative complications were investigated and analyzed. Results The intraoperative blood loss in the observation group was significantly less than that in the control group, and the operation time, fracture healing time and length of stay were significantly shorter than those in the control group. The degree of joint flexion in the observation group was significantly higher than that in the control group, and the score of Bostman was significantly higher than that of the control group. The incidence of postoperative complications in the observation group(3.33%) was significantly lower than that in the control group(15%), and there was a significant difference between the two groups. Conclusion It is effective and safe to treat the comminuted patellar fracture with needle tail hole self folding patellar needle and tension band steel wire. It is worth to be widely applied.
引文
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[11]Brown MJ,Bisson LJ,Anders MJ.Tibial Tubercle Fracture After Bone-Patellar Tendon-Bone Autograf[tJ].Am J Orthop(Belle Mead NJ).2016;45(7):E469-E471.
[12]俞益火,田治标,吴锦熙,等.三种手术方式治疗髌骨骨折的体会[J].临床骨科杂志,2013,16(5):591-592.3969.
[13]黄明辉.髌骨骨折的治疗进展[J].中国临床医生,2013,41(4):13-15.
[14]韦秀芳,疏致富,孙军,等.不同内固定方法治疗粉碎性髌骨骨折疗效分析[J].实用骨科杂志,2013,19(12):1143-1146.
[15]胡昌庆,李关兴,李龙付,等.3种张力带内固定治疗髌骨骨折的临床疗效分析[J].实用骨科杂志,2013,19(4):366-368.
[2]蒋正武,谢跃,赵越,等.钢丝环扎、髌骨爪、多克氏针钢丝张力带固定治疗粉碎性髌骨骨折的疗效比较[J].山东医药,2013,53(45):53-54.
[3]许广达,郭荣光.张力带别针系统治疗髌骨骨折[J].实用骨科杂志,2013,19(10):951-953.
[4]Sugimura N,Hirose D,Aso K,et al.Efficacy and Limitations of Conservative Treatment for Painful Patella Partita:Positioning of an Ultrasound-Accelerated Fracture Healing Apparatus[J].J Orthop Trauma.2017;31(7):S2.
[5]聂柳青.微创手术治疗横断型髌骨骨折18例临床观察[J].湖南师范大学学报(医学版),2008,5(3):71-72.
[6]米仕第.髌骨骨折不同治疗方法的临床疗效比较[J].海南医学,2014,12(13):1918-1920.
[7]高二娥.128层螺旋CT三维成像在骨关节外伤中的临床应用价值讨论[J].湖南师范大学学报(医学版),2015,12(4):32-33,34.
[8]张涛,李海峰,何勍,等.髌骨固定针与克氏针张力带治疗髌骨骨折的病例对照研究[J].中国骨伤,2013,26(6):453-456.
[9]李海凤,李海燕.粉碎性髌骨骨折术后康复治疗的效果[J].江苏医药,2015,41(2):212-213.
[10]Khan I,Dar MY,Rashid S.Butt MF.Internal Fixation of Transverse Patella Fractures Using Cannulated Cancellous Screws with Anterior Tension Band Wiring[J].Malays Orthop J.2016;10(2):21-26.
[11]Brown MJ,Bisson LJ,Anders MJ.Tibial Tubercle Fracture After Bone-Patellar Tendon-Bone Autograf[tJ].Am J Orthop(Belle Mead NJ).2016;45(7):E469-E471.
[12]俞益火,田治标,吴锦熙,等.三种手术方式治疗髌骨骨折的体会[J].临床骨科杂志,2013,16(5):591-592.3969.
[13]黄明辉.髌骨骨折的治疗进展[J].中国临床医生,2013,41(4):13-15.
[14]韦秀芳,疏致富,孙军,等.不同内固定方法治疗粉碎性髌骨骨折疗效分析[J].实用骨科杂志,2013,19(12):1143-1146.
[15]胡昌庆,李关兴,李龙付,等.3种张力带内固定治疗髌骨骨折的临床疗效分析[J].实用骨科杂志,2013,19(4):366-368.