分体式髌骨爪结合加压空心埋头钉治疗髌骨粉碎性骨折的临床研究

Effect of split patella claw and cannulated screw on patients with comminuted patella fracture

目的探讨分体式髌骨爪结合加压空心埋头钉治疗髌骨粉碎性骨折的临床疗效。方法选择南通大学附属医院骨科2016年5月至2017年6收治的96例髌骨粉碎性骨折患者,按随机数表法将患者分为观察组和对照组,每组48例,对照组给予分体式髌骨爪治疗,观察组给予分体式髌骨爪结合加压空心埋头钉治疗,比较两组患者的手术时间、术中出血量、骨折愈合时间、膝关节HSS评分及术后并发症情况。结果观察组和对照组患者的手术时间[(63.2±2.9)min vs(62.9±2.8)min]、术中出血量[(98.3±3.2)m L vs(98.1±3.1)m L]、骨折愈合时间[(9.9±1.9)d vs(10.1±1.8)d]比较,差异均无统计学意义(P>0.05);观察组患者的膝关节HSS评分优良率为93.8%,明显高于对照组的75.0%,差异有统计学意义(P<0.05);患者术后并发症发生率为6.3%,明显低于对照组的29.2%,差异有显著统计学意义(P<0.01)。结论分体式髌骨爪结合加压空心埋头钉治疗髌骨粉碎性骨折疗效显著,其可有效促进骨折愈合,有利于术后早期膝关节功能的恢复,且并发症少。

Objective To discuss the clinical efficacy of split patella claw and cannulated screw on patients with comminuted patella fracture. Methods A total of 96 cases of comminuted patella fracture from Department of Orthopedics and Hospital Affiliated to Nantong University during May 2016 to June 2017 were divided into the observation group（n=48） and the control group（n=48）. The observation group was treated with split patella claw, and the control group was treated with cannulated screw. Then the operation time, intraoperative blood loss, fracture healing time,knee joint HSS score and complication were contrasted between the two groups. Results There was no significant difference in operation time, intraoperative blood loss and fracture healing time between the two groups：（63.2±2.9） min vs（62.9 ± 2.8） min,（98.3 ± 3.2） m L vs（98.1 ± 3.1） m L,（9.9 ± 1.9） d vs（10.1 ± 1.8） d, P〉0.05. HSS score excellent rate was93.8% in the observation group, significantly higher than 75.0% in the control group（P〈0.05）. Complication rate was6.3% in the observation group, significantly lower than 29.2% in the control group（P〈0.01）. Conclusion Split patella claw combined with cannulated screw is effective in the treatment of comminuted fracture of patella, which can promote fracture healing and early recovery of knee function, with less complications.