摘要
目的探讨关节镜辅助下闭合复位内固定治疗髌骨骨折的手术方法及近期临床疗效。方法2004年6月-2008年7月,采用关节镜辅助下闭合复位内固定治疗42例髌骨骨折患者。男28例,女14例;年龄16～59岁,平均35岁。左膝19例,右膝23例。致伤原因:交通伤21例,摔伤11例,运动伤7例,挤压伤3例。均为新鲜闭合骨折,其中横形骨折38例,星状骨折4例。受伤至手术时间为3～42h,平均12h。膝关节功能根据Lysholm评分为(68.60±15.20)分。本体感觉测试错误位置觉为(3.72±0.12)°。结果术后切口均Ⅰ期愈合,无相关并发症发生。42例均获随访,随访时间12～39个月,平均16个月。X线片示术后6～9周,平均7周骨折愈合。末次随访时38例膝关节屈曲度达正常范围,4例活动范围受限。23例患肢髌上15cm大腿部周径同健侧肢体,19例较健侧平均萎缩0.7cm。膝关节功能Lysholm评分为(95.10±3.92)分,膝关节错误位置觉为(2.06±0.11)°,与术前比较差异均有统计学意义(P<0.05)。结论关节镜辅助下闭合复位内固定术在可视下骨折复位,术中可行关节腔冲洗,同时修补其他损伤组织,手术创伤小,并发症少,是治疗髌骨骨折的有效方法之一。
Objective To explore the surgical method and clinical short-term outcomes of internal fixation combined closed reduction with arthroscope aid in treating patellar fracture.Methods From June 2004 to July 2008,42 patients with fresh simple patellar fracture underwent internal fixation combined closed reduction with arthroscope aid,included 28 males and 14 females,aged 16-59 years（35 years on average）.The locations were 19 left knees and 23 right knees.Injury was by traffic accident in 21 cases,by falling in 11 cases,by sports in 7 cases and by crush in 3 cases.All the patients had fresh closed fracture,including 38 cases of transverse fracture and 4 cases of stellate fracture.The Lysholm score was 68.60±15.20; the proprioceptive function of the knee joints was（3.72±0.12）°.The time from injury to operation was 3-42 hours（12 hours on average）.After the treatment of affiliated injury under the arthroscope,patellar fracture was reduced with manipulation method,fracture was fixed with tensile force screw or modified tension band.Results All incisions obtained healing by first intention after operation,42 patients were followed up for 12-39 months（16 months on average）.The X-ray films showed callus at the fracture and the smooth cartilage surface 6-9 weeks（7 weeks on average）after operation.The flexed motion range of knee joint at last follow-up was at normal range in 38 cases,was limited in 4 cases.Circumference of suffered limbs 15 cm above the patella was the same as normal ones in 23 cases,atrophied 0.7 cm in 19 cases.There were no breakage of internal fixation and shift of fracture and patellofemoral arthritis at last follow-up.The proprioceptive function of the knee joints was（2.06±0.11）° and the Lysholm score was 95.10±3.92;all showing statistically significant differences when compared with preoperation（P 0.05）.Conclusion This treatment method has advantages as follows：mini-wound,early exercises and few complications, which can rinse articular cavity and repair the affiliated injury at the same time.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第1期11-13,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
关节镜
髌骨骨折
闭合复位
内固定
近期疗效
Arthroscope Patellar fracture Closed reduction Internal fixation Short-term outcome
