张力带与髌骨爪置入治疗单纯横行和粉碎性髌骨骨折疗效分析

目的比较张力带和髌骨爪置入治疗单纯横行骨折和粉碎性骨折患者疗效,为临床两种手术方法的选择提供依据.方法对接受治疗的38例髌骨骨折患者进行回顾性分析,其中20例患者采用张力带疗法,18例患者采用髌骨爪疗法,比较不同疗法患者手术时间、术中出血量、并发症发生率、骨折愈合时间、膝关节功能恢复情况.结果张力带固定组患者术中出血量(305.2±36.5)m L,显著高于髌骨爪固定组患者(283.4±24.8)m L(P0.05),张力带固定组粉碎性骨折患者平均手术时间(54.1±9.1)min,显著长于髌骨爪固定组粉碎性骨折患者(52.9±2.8)min(P0.05).两组患者骨折愈合时间无显著性差异(11.9±1.9,12.4±1.8)周,膝关节功能评价平均分髌骨爪固定组患者(78.7±9.3)分,显著优于张力带固定组患者(84.7±9.2)分(P0.05).结论对于一般髌骨横行骨折患者,可采用张力带固定方式,而对于年龄较大、身体素质较差、粉碎性骨折患者,推荐采用髌骨爪固定方式,以减少术后并发症发生,促进膝关节功能恢复.

Analysis on Therapeutic Effects of Tension-band Wire and Patellar Holder for Treatment of Transverse and Comminuted Patellar Fracture

Objective To compare the therapeutic effects of tension-band wire and patellar holder on transverse patellar fractures and comminuted patellar fracture, and to provide evidence for choosing appropriate treatment method in clinic. Method The clinic data of 38 patients with patellar fracture were respectively analyzed. Among them,20 patients were treated with tension-band wire and 18 patients were treated with patellar holder. The operation time, peroperative bleeding, complication incidence, average healing time, recovery of knee joint were compared between patients treated with tension-band wire or patellar holder. Results The peroperative bleeding volume of the tension-band wire group was significantly higher ( 305 . 2 ± 36 . 5 ) mL than that of the patellar holder group (283. 4±24. 8)mL (P<0. 05). The operation time of comminuted patellar fracture patients treated with tension-band wire (54. 1±9. 1)min was significantly longer than that of comminuted patellar fracture patients treated with patellar holder ( 52 . 9 ± 2 . 8 ) min ( P<0 . 05 ) . There was no significantly differences in average healing time between the two groups (11. 9 ±1. 9,12. 4 ±1. 8) weeks. The average SSH score of the patients treated with patellar group ( 78 . 7 ± 9 . 3 ) min was significantly higher than the patients treated with tension-band wire (84. 7 ±9. 2) min. Conclusion Tension-band wire should be the routine method for treating transverse patellar fracture for its low cost and easy to spread. Patellar holder should be used in older patients or the patients with comminuted patellar fracture to reduce the incidence of complication, and to promote the recovery of knee-joint function.