关节镜辅助下无头加压螺钉固定治疗髌骨横型骨折∗

摘要

Objective To observe the clinical effect of headless compression Screw (HCS)under arthroscope in the treat-ment of patella fracture.Methods Nineteen patients of patella transverse fractures were selected,all of them were treated with HCS fixation under arthroscope,reviewed and followed-up after surgery.Results X-ray examination after surgery of 3 -5 weeks found that the fracture lines blurred or disappeared,and the patella articular surface was smooth without displacement.The healing time of fracture was 8 weeks on average after operation;There was no statistical difference in the range of the knee joint in the af-fected side in (135.42±5.82)°and the contralateral side in (139.38±6.55)°(P >0.05);The knee Lysholm score of the last follow-up was 86-100 points[(93.7±4.14)points],which was significantly higher than the preoperative score of 65.7 (P <0.05);There was no fracture displacement in the period of followed-up,drop of internal fixator,fracture and other complications.Conclusion HCS fixation under arthroscope in treatment of patella fracture is effective.The joint function recovered quickly with less complica-tion.It could be one of the effective methods for the treatment of patella transverse fracture.%目的：探讨关节镜下采用无头加压螺钉(HCS)固定治疗髌骨横型骨折的临床疗效。方法选择髌骨橫型骨折患者19例，采用关节镜辅助下无头加压螺钉固定治疗，术后复查并随访。结果术后3~5周行 X 线片骨折线模糊或消失，髌骨关节面平整无位移，术后骨折愈合时间平均8周；患侧膝末次膝关节活动范围[(135.42±5.82)°]与健侧活动范围[(139.38±6.55)°]差异无统计学意义(P >0.05)。末次随访膝关节 Lysholm 评分86~100分，平均(93.7±4.14)分，显著高于术前评分65.7分(P <0.05)；随访期内无骨折移位，内固定物脱落、断裂等并发症。结论关节镜辅助下 HCS 固定治疗髌骨横行骨折，关节功能恢复快，且术后并发症少，是治疗髌骨橫型骨折的有效方法之一。