可调式髌骨爪结合可吸收线与克氏针钢丝张力带修复粉碎性髌骨骨折的比较

摘要

BACKGROUND:High-energy patelar comminuted fracture significantly increased. Single fixation cannot meet the requirement of anatomical repositioning of the patela, multiple-point strong fixation, and early functional exercise. OBJECTIVE:To compare the clinical effect of adjustable patela claws + absorbable suture and Kirschner wire tension band in the repair of comminuted patelar fractures. METHODS: A total of 57 patients with comminuted patela fracture were randomly selected and randomly assigned to two groups. 29 cases received open reduction and adjustable patela claws + absorbable suture fixation. 28 cases received open reduction and Kirschner wire tension band fixation. Operative time, incision length, fracture healing time, postoperative complications and Hospital for Special Surgery knee function scores were compared between the two groups, and then statistical analysis was conducted. RESULTS AND CONCLUSION:No significant difference in incision length and operative time was detected between the adjustable patela claws + absorbable suture group and Kirschner wire tension band group. Significant differences in healing time, incidence of complications and knee function after treatment were observed between the two groups, and above indications were better in the adjustable patela claws + absorbable suture group than in the Kirschner wire tension band group (P < 0.05). These results confirm that compared with the Kirschner wire tension band, adjustable patela claws + absorbable suture in repair of patelar comminuted fracture has some advantages such as short healing time, less postoperative complications, as wel as good functional recovery of knee joint. The fixation is accorded with biomechanical principle of internal fixation, simple to operate, firmly fixed, and has good prospects.%背景：高能量下髌骨粉碎性骨折明显增多，单一的内固定已无法满足髌骨解剖复位、多点坚强固定及早期功能锻炼的要求。目的：比较切开复位可调式髌骨爪+可吸收线与克氏针钢丝张力带修复粉碎性髌骨骨折的临床效果。方法：纳入粉碎性髌骨骨折患者57例，随机分为2组，29例采用切开复位可调式髌骨爪+可吸收线固定，28例切开复位克氏针钢丝张力带固定。对比观察两组手术时间、切口长度、骨折愈合时间、治疗后并发症及膝关节功能美国特种外科医院评分，并进行统计学分析。结果与结论：可调式髌骨爪+可吸收线固定组与克氏针钢丝张力带固定组切口长度、手术时间方面的差异无显著性意义；两组在骨折愈合时间、并发症发生率及治疗后膝关节功能方面的差异有显著性意义，可调式髌骨爪+可吸收线固定组优于克氏针钢丝张力带固定组(P <0.05)。提示与克氏针钢丝张力带相比，可调式髌骨爪+可吸收线固定修复髌骨粉碎性骨折具有骨折愈合时间短、治疗后并发症少、膝关节功能恢复好等优点，固定符合生物力学内固定的原则，且操作简便，固定牢靠，具有良好的应用前景。