摘要
目的:探讨采用带孔克氏针横向固定结合钛缆荷包缝合治疗髌骨粉碎性骨折难复性骨折块的临床疗效。方法:回顾性分析2014年1月至2016年1月采用带孔克氏针横向固定结合钛缆荷包缝合治疗的17例髌骨粉碎性骨折患者,其中男10例,女7例;年龄28～67(48.7±3.2)岁;骨折按OTA/AO系统分型均为34-C3.2型。观察患者的手术时间、术中出血量、术后膝关节首次锻炼时间及术后并发症情况,术后10个月根据B觟stman髌骨骨折功能评分对其功能恢复进行评定。结果:17例患者术后获得随访,时间10～24 (14.6±2.1)个月。所有患者伤口甲级愈合,骨折临床愈合时间11.7～16.5(12.7±1.7)周。手术时间67～95(71.4±11.5) min,术中出血量41～72(57.0±7.5) ml,术后首次关节功能锻炼时间2～5(2.2±1.7) d。术后无针尾穿破皮肤及克氏针松动滑脱、针尾痛性滑囊炎,无钛缆脱套、断裂等并发症发生。术后10个月B觟stman髌骨骨折功能评分28.15±1.74,其中优秀12例,良好4例,失败1例。结论 :带孔克氏针横向固定结合钛缆荷包缝合治疗髌骨粉碎性骨折难复性骨折块具有手术操作简单、关节面解剖复位好、内固定牢靠、并发症少的优势,值得临床推荐。
Objective：To explore clinical effects of Kirschner wire with hole transverse fixation combined with titanium cable purse string suture in treating refractory fracture of patellar comminuted fracture. Methods：From January 2014 to January 2016,17 comminuted fracture treated by Kirschner wire with hole transverse fixation combined with titanium cable purse string suture were retrospectively analyzed,including 10 males and 7 females aged from 28 to 67 years old with an average of（48.7 ±3.2） years old. According to AO/OTA fracture classification,all fractures were type 34-C3.2. Operative time,blood loss,intervals of the first functional exercise postoperatively and complications were observed. Meanwhile,function recovery was evaluated by Bostman scoring at 10 months after operation. Results：All patients were followed up with an average of（14.6±2.1） months ranged from 10 to 24 months. All incisions healed at stage Ⅰ. Clinical fracture healing time ranged from 11.7 to16.5 weeks with an average of（12.7±1.7） weeks; operative time ranged from 67 to 95 min with an average of（71.4±11.5）min; blood loss ranged from 41 to 72 ml with an average of（57.0±7.5） ml; the first time of functional exercise ranged from 2 to5 d with an average of（2.2±1.7） d. No complications including Kirschner pin stabbing the skin,loose or slippery of Kirschner pin,bursitis with pain brought by tip of Kirschner pin,wire escaped and broken occurred. Postoperative Bostman score at 10 months were 28.15±1.74,12 patients got excellent results,4 well and 1 lose. Conclusion：Kirschner wire with hole transverse fixation combined with titanium cable purse string suture in treating refractory fracture of patellar comminuted fracture has advantages of simple operation,good anatomical reduction,stable fixation and less complications,which is worth popularizing.
作者
杨荣
杨晓东
舒帆
张浩
YANG Rong;YA NG Xiao-dong;SHU Fan;ZHANG Hao(Department of Orthopaedics,Ningbo No.9 Hospital,Ningbo 315020,Zhejiang,China)
出处
《中国骨伤》
CAS
2018年第10期894-898,共5页
China Journal of Orthopaedics and Traumatology
关键词
髌骨
骨折
粉碎性
骨折固定术
内
缝合技术
Patella
Fracture,comminuted
Fracture fixation,internal
Suture technique
