带线锚钉结合缝线捆扎固定髌骨下极粉碎性骨折

Treatment of comminuted fracture of inferior pole of patella with suture anchor combined suture binding

目的探讨带线锚钉结合缝线捆扎固定髌骨下极粉碎性骨折的手术技术及临床疗效。方法选取2019年1月至2022年1月成都市第一人民医院经带线锚钉结合缝线捆扎缝合治疗的19例患者作为实验组,行钢丝垂直间断固定的20例患者作为对照组。对2组患者的术后膝关节活动度(ROM)、Bostman评分、膝前痛、骨愈合时间进行疗效评估比较。计量资料以采用t检验,计数资料使用卡方检验。结果实验组患者无骨不愈合及膝前痛发生,平均骨愈合时间为(2.5±0.5)个月,低于对照组的(3.2±0.7)个月(t=3.577,P<0.05)。实验组患者末次随访时ROM为(131.7±5.6)°,高于对照组的(116.5±7.0)°(t=7.481,P<0.05)。实验组患者Bostman评分平均为(27.3±2.1)分,高于对照组的(22.5±2.9)分(t=5.922,P<0.05)。结论带线锚钉结合缝线捆扎缝合固定髌骨下极粉碎性骨折是一种简单、有效的手术方式,可以获得良好的临床疗效且无需二次手术取出内固定。

Objective To explore the surgical technique and clinical efficacy of suture anchor combined with suture binding for the fixation of comminuted fractures of the inferior pole of the patella.Methods A total of 19 patients treated with suture anchor and suture binding at Chengdu First People's Hospital from January 2019 to January 2022 were selected as the experimental group,while 20 patients treated with vertical intermittent steel wire fixation were selected as the control group.The postoperative range of motion(ROM)of knee joint,Bostman score,anterior knee pain,and bone healing time between two groups were evaluated and compared.The measurement data were analyzed by t test;counting data were analyzed by chi square test.Results No bone non-union or knee pain occurred in the experimental group;the average bone healing time was(2.5±0.5)months,which was shorter than(3.2±0.7)months of the control group(t=3.577,P<0.05).At the last follow-up,the average ROM of the experimental group patients was(131.7±5.6)°,which was larger than(116.5±7.0)°of the control group(t=7.481,P<0.05).The average Bostman score of the experimental group was(27.3±2.1),which was higher than(22.5±2.9)of the control group(t=5.922,P<0.05).Conclusion The combination of suture anchor and suture binding is a simple and effective surgical method for the fixation of comminuted fractures of the lower pole of the patella,which can achieve good clinical efficacy without the need for secondary surgical removal and internal fixation.