经皮穿刺克氏针钢丝张力带固定术治疗髌骨骨折

Percutaneous internal fixation with Kirschner needles combined with tension band wires for the treatment of patella fractures

目的：探讨经皮穿刺克氏针钢丝张力带固定术治疗髌骨骨折的临床疗效。方法：回顾2001年7月以来采用经皮穿刺克氏针钢丝张力带固定术治疗23例髌骨骨折，男13例，女10例；年龄最大76岁，最小19岁，平均36．5岁。骨折分型：横行骨折12例，斜行骨折4例，粉碎性骨折7例。手术时间为伤后1周内完成。结果：本组23例均获得随访，随访时间6～72个月。随访内容包括：术后骨折复位情况、骨折愈合时间、膝关节活动范围、是否膝关节疼痛，及术后是否出现骨折移位、骨不连、感染及创伤性关节炎等并发症。根据Merchan临床评分标准，结果为：优16例，良7例。结论：经皮穿刺克氏针钢丝张力带固定术治疗髌骨骨折是一种微创手术，具有创伤小、恢复快及美观等特点，同时能提供髌骨骨折早期活动足够强度，膝关节功能恢复满意。

Objective： To study the therapeutic effects of pereutaneous internal fixation with Kirschner needles combined with tension band wires for the treatment of patella fracture. Methods： Twenty-three patients with patella fractures were treated with percutaneous internal fixation with Kirschner needles combined with tension band wires from 2001.7. Among them, 13 patients were male and 10 were female,ranging in age from 19 to 76 years（mean 36.5 years）. Twelve patients were transverse fracture, 4 were oblique fracture and 7 comminuted fracture. The operation was completed within one week after trauma. Results： All the patients were followed up from 6 to 72 months. According to Merchan＇s evaluation standards, which including postoperative reduction,the time of fracture healing, motion range of knee joint, occurrence of knee joint pain and such complications as displacement, non-union, infection and traumatic arthritis, 16 patients reached excellent results and 7 good. Conclusion： Pereutaneous internal fixation with Kirschner needles combined with tension band wires for the treatment of patella fracture posseses following advantages： mini-wound, rapid recovery, beautiful outlook, strong enough to insure early motion and satisfactory recovery of knee joint.