摘要
[目的]探讨运用爱惜邦行髌韧带编织固定,结合钛缆捆扎技术治疗老年骨质疏松性髌骨下极骨折的临床疗效。[方法]回顾性分析2014年1月~2015年9月本院收治入院的42例老年髌骨下极骨折患者资料,男18例,女24例,年龄59~72岁,闭合骨折38例,开放骨折4例(均为Gustilo I型骨折)。受伤至手术时间平均为2.8 d(8 h^5 d)。术中先采用爱惜邦对髌韧带编织缝合后复位骨折,经骨隧道固定于髌骨上极,再结合钛缆环扎固定,必要时加用张力带固定。术后随访观察骨折愈合时间及膝关节功能,采用Bostman髌骨骨折功能评分标准评定患肢功能。[结果]术后患者随访8~28个月(平均18个月),骨折愈合时间9~12周,无伸膝无力、无内固定移位及断裂者。术后8个月按照Bostman髌骨骨折功能评分:平均28.9分,其中优33例,良9例,优良率100%。膝关节稳定性良好,末次随访膝关节平均活动度:伸直-1°,屈曲127°。所有患者股四头肌力5级,行走恢复至术前状态。[结论]线缆固定技术可有效的治疗老年髌骨下极骨折,固定牢固可靠,特别适用于髌骨下极骨块较小、骨质疏松的患者,有利于术后早期进行膝关节功能锻炼,避免关节僵硬,是治疗老年髌骨下极骨折一个简便可行的方法。
[Objective] To investigate the clinical outcome of Ethibond suture combined with titanium cable cerclagefor fixation of patellar inferior pole fracture in the elderly. [Methods] Forty-two patients suffering from patellar inferior pole fractures were trested with intcrnal fixation of Ethibond suture combined with titanium cable cerclage in our hospital from January 2014 to September 2015.The patients included 18 males and 24 females aged from 59 to 72 years old. The average time from injurey to surgery was 2.8 days （range, 8 hours to 5 days） . At the beginning of the surgery, the patellar tendon was sutured with Ethidond,then the inferior pole fragment was reduced with the main body of patella by pulling and tying the suture through tthe Ibone ttmmel, ~ file whole patella was fixed with titanium cable cerclage cerclage. If necessary, a ＂8＂ shaped ：tension band fixation was added. The range of motion of the affected knee, fracture healing time, and Bostman score were assessed toevaluate the knee function and the clinical outcome. [ Results ] All 42 patients were followed up for 8 to 28 months with an average of 18 months.All the fractures healed from 9 weeks to 12 weeks after surgery. No internal fixation fail- ure or knee weakness was observed in any patient. At 8 months after surgery, the mean Bostman functional score was 28.9 ：points, including 33 .cases ,of exoellent outcome, 9 cases of good outcome, which meant the overall good to excellent outcomes ,rate was i：I00%.：Satisfactory t stability of affected knee achieved in all cases. At the last follow-up, the mean ranges of the knee joint motion were from 1° of exiension to 127° of flexion. The femoral quadriceps strength of the affected limb reached to Grade 5 after functional exercises.All patients regained preoperative walk ability. [Conclusion] Internal fixation using Et- hibond suture combined with titanium cable cerclage does treat inferior pole fracture of patella effectively, which is especiallysuitable for the elderly patients with osteoporosis and small fracture fragment.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第14期1308-1312,共5页
Orthopedic Journal of China
基金
国家自然科学基金资助项目(编号:81572188)
关键词
髌骨下极
骨折
内固定
治疗效果
线缆
distal pole of patella, fracture, internalfixation, treatment outcome, Ethibond suture, titanium cable
