直视复位后联合应用克氏针与记忆合金聚髌爪治疗髌骨粉碎骨折的疗效

Clinical Application of the Combination of Kirschner Pins and Patellar Concentrator on Comminuted Patellar Fracture

目的探讨直视复位、克氏针及形状记忆合金聚髌爪联合应用治疗髌骨粉碎骨折的疗效及适应证。方法对36例髌骨粉碎性骨折的患者采用股四头肌扩张部切开、股四头肌扩张部切开加髌韧带部分切开或股四头肌扩张部切开加髌韧带Z型切开的方法翻转髌骨直视下复位,以克氏针固定粉碎骨折块使髌骨关节面侧达解剖复位,再以形状记忆合金聚髌爪固定已解剖复位的髌骨,观察其疗效。结果36例均获4～21个月的随访,平均10.4个月。术中直视下、术中X线透视、术后X线片均提示骨折解剖复位,克氏针及记忆合金聚髌爪固定良好,功能评定平均94.6分。结论直视复位、克氏针与记忆合金聚髌爪联合应用,适用于髌骨粉碎骨折的治疗,复位固定确切牢固。术后功能恢复良好。

Objective To evaluate the effect and indications of the combination of Kirschner pins and patellar concen-trator following the reduction under direct vision for comminuted patellar fracture. Methods Thirty-six patients with comminuted patellar fracture were treated with visible reduction following patellar resupination by incision of the bulge of quadriceps femoris, or combined with partial or Z-type incision of patellar ligament, fixing the comminuted bones with Kirschner pins for anatomic reduction of the articular surface, and then fixing the reduced patella with patellar concentrator. Results Follow-ups was conducted 4 to 21 months, with an average of 10. 4 months for all 36 cases. X-rays during the operation and after the operation revealed anatomic reduction of the fractured bone, with Kirschner pins and patellar concentrator firmly hold. The average grade after operation was 94.6. Conclusion The combination of Kirschner pins and patellar concentrator following the reduction under direct vision for comminuted patellar fracture is suitable for comminuted patellar fracture, with a stable fixation. And the post -fictional recovery is good.