改良带孔骨针钛缆张力带联合经骨道“8”字减张带治疗髌骨下极骨折
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摘要
目的探讨改良带孔骨针钛缆张力带联合经骨道"8"字减张带与钛缆张力带组固定治疗髌骨下极骨折的疗效对比。方法选取2015年1月至2017年1月北京市通州区中西医结合医院骨科髌骨下极骨折患者60例,30例采用改良带孔骨针钛缆张力带联合经骨道"8"字减张带内固定(改良组),30例采用钛缆张力带内固定(钛缆张力带组)。所有患者均获得9~15个月随访,平均11.8个月。结果改良组屈膝角度平均为(111.3±13.5)°,钛缆张力带组平均为(97.8±21.7)°,两组比较差异有统计学意义(P <0.05),而在手术时间、骨折愈合时间方面差异均无统计学意义。末次随访,改良组总体优良率为90.0%,钛缆张力带组为76.7%;钛缆张力带组内固定松动2例,其中1例进行二次手术治疗,改良组未见内固定松动。结论髌骨下极骨折采用改良钛缆张力带加"8"字减张带固定对于骨折的恢复更加有利,安全性高,疗效肯定,可作为髌骨下极骨折的一种治疗方案。
Objective To compare the efficacy of the modified perforated bone titanium wire tension band combined with the "8" reduction band(the modified group) and the titanium cable tension band in the treatment of the patellar lower pole fracture. Methods From January 2015 to January 2017, 60 patients with patella lower pole fractures were selected. Thirty patients were treated with modified perforated titanium needle tension band and internal bone graft with "8" reduction band, 30 patients were treated with titanium cable tension band internal fixation. All patients were followed up for 9-15 months. Results The average knee flexion angle was(111.3 ± 13.5)° in the modified group, and the average knee flexion angle was(97.8 ±21.7) ° in the titanium cable tension band group, there was significant difference between the two groups(P < 0.05). There was no significant difference in duration of operation and fracture union time between the two groups. At the end of follow-up, the overall excellent and good rate was 90.0% in the modified group, 76.7% in the titanium cable tension band group. Internal fixation was loosened in 2 cases in the titanium cable tension band group, one case was treated with secondary surgery, and no internal fixation was loosened in the improved group. Conclusions Modified titanium cable tension band and "8" reduction band fixation can be used as a treatment for patellar lower pole fracture with high safety, and affirmative effect.
Objective To compare the efficacy of the modified perforated bone titanium wire tension band combined with the "8" reduction band(the modified group) and the titanium cable tension band in the treatment of the patellar lower pole fracture. Methods From January 2015 to January 2017, 60 patients with patella lower pole fractures were selected. Thirty patients were treated with modified perforated titanium needle tension band and internal bone graft with "8" reduction band, 30 patients were treated with titanium cable tension band internal fixation. All patients were followed up for 9-15 months. Results The average knee flexion angle was(111.3 ± 13.5)° in the modified group, and the average knee flexion angle was(97.8 ±21.7) ° in the titanium cable tension band group, there was significant difference between the two groups(P < 0.05). There was no significant difference in duration of operation and fracture union time between the two groups. At the end of follow-up, the overall excellent and good rate was 90.0% in the modified group, 76.7% in the titanium cable tension band group. Internal fixation was loosened in 2 cases in the titanium cable tension band group, one case was treated with secondary surgery, and no internal fixation was loosened in the improved group. Conclusions Modified titanium cable tension band and "8" reduction band fixation can be used as a treatment for patellar lower pole fracture with high safety, and affirmative effect.
引文
[1]杨小华,李国平,穆怀昭,等.AO钛缆系统治疗髌骨骨折的疗效[J].广东医学,2013,34:281-283.
[2]孙海波,周君琳,张万龙,等.钛缆环扎联合8字减张带治疗髌骨下极粉碎性骨折[J].实用骨科杂志,2015,21:217-219,286.
[3]王树相,邱菊,郭广明.微创闭合复位内固定术治疗髌骨骨折的临床研究[J].中国现代医生,2010,48:159-160.
[4]张晓光,袁瑞新,李东亮.膝关节镜下复位空心钉内固定治疗髌骨骨折的体会[J].北京医学,2017,39:1081-1082.
[5]张华,李贵山,方永刚.带线锚钉内固定治疗髌骨下极骨折[J].中国骨与关节损伤杂志,2014,29:78-79.
[6]吴庭东,蒋毅,张满江.镍钛聚髌器与改良张力带钢丝治疗髌骨骨折的对比研究[J].北京医学,2010,32:304-306.
[7]马建兵,王晓安,陈明凡,等.张力带固定与下极切除治疗髌骨下极骨折[J].中国矫形外科杂志,2000,7:22-23.
[8]黄华溢,夏宏伟,崔豫宝,等.空心钉内固定在髌骨骨折中的应用[J].北京医学,2015,37:75-76.
[9]雷宁波,邢涛,董林.钢丝环扎加记忆合金髌骨爪治疗髌骨下极骨折[J].临床骨科杂志,2016,19:320,323.
[10]席勇,王树金,王遥伟.交叉克氏针结合钢丝捆扎治疗髌骨下极骨折[J].临床骨科杂志,2017,20:124.
[11]单宇,蒋富贵,鞠文,等.钛缆“8”字加“0”形环扎治疗髌骨骨折[J].生物骨科材料与临床研究,2013,10:49-50.
[12]葛勇,陈海磊,陆新林,等.线缆系统内固定治疗肩锁关节脱位和锁骨远端骨折[J].中国骨与关节损伤杂志,2016,31:310-311.
[13]朱爱国,李景峰,葛勇,等.2种不同内固定方法治疗髌骨骨折的疗效分析[J].中国骨与关节损伤杂志,2017,32:627-629.
[14]Werner GDA,Gemmell P,Grosser S,et al.Analysis of a deep transcriptome from the mantle tissue of Patella vulgata Linnaeus(Mollusca:Gastropoda:Patellidae)reveals candidate biomineralising genes[J].Mar Biotechnol(NY),2013,15:230-243.
[2]孙海波,周君琳,张万龙,等.钛缆环扎联合8字减张带治疗髌骨下极粉碎性骨折[J].实用骨科杂志,2015,21:217-219,286.
[3]王树相,邱菊,郭广明.微创闭合复位内固定术治疗髌骨骨折的临床研究[J].中国现代医生,2010,48:159-160.
[4]张晓光,袁瑞新,李东亮.膝关节镜下复位空心钉内固定治疗髌骨骨折的体会[J].北京医学,2017,39:1081-1082.
[5]张华,李贵山,方永刚.带线锚钉内固定治疗髌骨下极骨折[J].中国骨与关节损伤杂志,2014,29:78-79.
[6]吴庭东,蒋毅,张满江.镍钛聚髌器与改良张力带钢丝治疗髌骨骨折的对比研究[J].北京医学,2010,32:304-306.
[7]马建兵,王晓安,陈明凡,等.张力带固定与下极切除治疗髌骨下极骨折[J].中国矫形外科杂志,2000,7:22-23.
[8]黄华溢,夏宏伟,崔豫宝,等.空心钉内固定在髌骨骨折中的应用[J].北京医学,2015,37:75-76.
[9]雷宁波,邢涛,董林.钢丝环扎加记忆合金髌骨爪治疗髌骨下极骨折[J].临床骨科杂志,2016,19:320,323.
[10]席勇,王树金,王遥伟.交叉克氏针结合钢丝捆扎治疗髌骨下极骨折[J].临床骨科杂志,2017,20:124.
[11]单宇,蒋富贵,鞠文,等.钛缆“8”字加“0”形环扎治疗髌骨骨折[J].生物骨科材料与临床研究,2013,10:49-50.
[12]葛勇,陈海磊,陆新林,等.线缆系统内固定治疗肩锁关节脱位和锁骨远端骨折[J].中国骨与关节损伤杂志,2016,31:310-311.
[13]朱爱国,李景峰,葛勇,等.2种不同内固定方法治疗髌骨骨折的疗效分析[J].中国骨与关节损伤杂志,2017,32:627-629.
[14]Werner GDA,Gemmell P,Grosser S,et al.Analysis of a deep transcriptome from the mantle tissue of Patella vulgata Linnaeus(Mollusca:Gastropoda:Patellidae)reveals candidate biomineralising genes[J].Mar Biotechnol(NY),2013,15:230-243.