老年人髌骨骨折钛镍记忆合金抓髌器内固定的临床分析

Clinical Application of the Memory Alloy PatellaConcentrator in treatment of Aged Patella Fractures

目的探讨老年人髌骨骨折特点及采用钛镍记忆合金抓髌器内固定的疗效。方法对1998年1月～2006年3月收治的62例老年人髌骨骨折,术前随机分成两组,A组30例,记忆合金抓髌器内固定。B组32例,克氏针钢丝张力带内固定。结果62例均获随访,随访时间6～24个月,平均12个月。根据术后X线片及关节功能恢复情况评定疗效。A组:2例操作时有小骨折块部分碎裂,骨折全部愈合,无内固定松动。术后疗效评价优良率96%。B组8例术中出现骨折块固定时不同程度的碎裂,10例克氏针松动,其中4例克氏针退出并针道浅表皮肤感染。3例骨折不愈合。术后疗效评价优良率69%,A、B两组比较有明显差异,<0.05。结论记忆合金抓髌器对髌骨骨折的治疗,尤其是老年人骨质疏松骨折效果确切,较传统方法更具有优越性,可减少手术并发症的发生。

Obiective To study the clinical effects of memory alloy patella concetrators in the treatment of aged patella fracture.Methods 62 cases of patella fracture were randomly treated with two different materials,1) by memory alloy patella concentrator (A group,30 cases);and 2) by Kirschner pin and steel wire tension band (B group,32 cases ).Result All cases were available for an average duration of follow-up of 12 months (range,6-24months).The patients were evaluated by radiographic representations and articular function.In group A,among 30 cases the osseous union reached 100%,the excellent and good results were 96%.In group B,among 32cases,nonunion were found in 3 cases,the excellent and good results were 69%.There were statistic differences between these two groups.Conclusion The use of memory alloy patella concentrators is appropriate for the treatment of patella fracture especially in aged person.Some complications caused by conventional internal fixa-tions can be avoided.