摘要
目的探讨可吸收线缝扎结合镍钛聚髌器治疗髌骨粉碎性骨折的临床疗效。方法 2005年10月~2009年12月,采用可吸收线缝扎结合镍钛聚髌器治疗髌骨粉碎性骨折53例。根据AO分型：B3型8例,C2、C3型45例。手术中确定髌骨满意复位后,先用粗可吸收线环行荷包缝合,间断缝合骨膜及髌前组织,视骨折块稳定情况,部分在髌前组织行＂8＂字张力带固定。再选用合适型号的镍钛记忆合金聚髌器固定,术中C臂机透视证实复位及固定良好。结果 38例获得随访4~18个月（平均8个月）,骨折愈合时间2~4个月;无内固定物松动、断裂及再骨折发生,术后发生切口表浅感染3例,膝关节滑膜炎2例,原有骨性关节炎一过性加重1例。按Lyshom＆G illqu ist膝关节评分标准,疗效优30例,良6例,可2例;优良率94.7%。结论可吸收线缝扎治疗髌骨粉碎性骨折具有较好的生物力学性能,能使骨折块紧密接触,固定可靠。镍钛聚髌器具有＂动力性张力带作用＂,可以复位及固定髌骨骨折,促进早期功能锻炼。采用可吸收线缝扎结合镍钛聚髌器治疗髌骨粉碎性骨折是一种值得推荐的治疗手段。
Objective To investigate the clinical effects of stabilizing comminuted patellar fractures with internal fixation by absorbable suture and nickel-titanium patellar concentrator.Methods Fifty-three cases of fresh comminuted patellar fractures were treated by internal fixation by absorbable suture and nickel-titanium patellar concentrator from Oct.2005 to Dec.2009.There were 37 males and 16 females,ranging from 17 to 72 years old（a mean of 36.8 years old）.According to AO classification,there were 8 cases of type B3 and 45 cases of type C2,C3.After satisfactory reduction of the comminuted patellar fractures during the operation,firstly we sewed up soft tissue around the patellar like a pouch with absorbable suture,partially added tention band fixation,then we used the NiTi concentrator to fix patellar fractures.Results Totally 38 cases out of 53 cases were followed up with a mean period of 8 months（6 months to 24 months）.All patients obtained bone union within 2 months to 4 months.No case of implant loosening or refracture was found.Three cases of infected incision,2 cases of postoperative traumatic arthritis and 1 case of temporary aggravation of pre-existing osteoarthritis were documented as postoperative complication.Of the 38 cases,30 cases scored excellent under the LyshomGillquist score,6 good and 2 fair.The excellent and good rate was 94.7%.Conclusion Absorbable suture has better characteristics of mechanism in treating comminuted patellar fracture,leading to closely contact fracture sites and reliably fix bone fragments.The nickel-titanium patellar concentrator is characterized by a dynamic tension band mechanism,which serves the role of reduction and fixation simultaneously and can facilitate early postoperative range of motion exercises.Selecting internal fixation with absorbable suture and utilizing nickel-titanium patellar concentrator provide a recommendable method for comminuted patellar fracture.
出处
《创伤外科杂志》
2011年第3期216-218,共3页
Journal of Traumatic Surgery
关键词
髌骨骨折
可吸收线
镍钛聚髌器
内固定
patellar fractures
absorbable suture
nickel-titanium patellar
internal fixator
