可吸收内植物张力带固定治疗髌骨骨折的生物力学与临床研究

Biomechanical and Clinical Evaluation of Biodegradable Tension Band on Treatment of Patella Fractures

目的探讨使用可吸收材料张力带内固定治疗髌骨骨折的可行性及其手术适应证、手术要点.方法在4具新鲜截肢标本上横行锯断髌骨,用两枚Biofix自身增强可吸收拉力螺钉代替克氏针,强生公司的PDSⅡ1号可吸收线代替钢丝,进行张力带固定,测定其固定强度.并在临床应用25例.结果在骨折端不加压时,可承受达55kg的牵拉力;当对骨折端进行加压时,可承受达60kg的牵拉力.全部病例均获随访,时间9～23个月,平均17个月.疗效:优20例,良5例.未出现炎症反应、感染、骨折再移位、断钉等并发症.平均骨折愈合时间为12周.结论可吸收内植物张力带固定治疗髌骨骨折方法简便,固定牢固、效果良好、不需二次手术,是治疗髌骨骨折理想的方法之一.

Objective To evaluate the biodegradable tension band for the treatment of patella fractures. Methods The extremities from 4 cadavers were used. Biofix screws and PDS Ⅱ - Ⅰ sutures were used to fix the artificial transverse patellar fractures, instead of Kirschners wire and steel wire. Tension was applied to the patella through the quadriceps tendon. The tension force was measured. Basing on the experimental results, 25 patients were treated dinically. Results The compressive fixation was more effective than common fixation. All of them could bear tension force over 55 kg. The patients were followed up for an average of 17 months （9- 23 months）. Among 25 patients, 20 were excellent, 5 were good. No complications such as infection, displacement or screw breakage happened. Bone union occurred after a mean time of 12 weeks. Conclusion Biodegradable tension band is promising in treating patella fractures because the second - time operation was not needed for the removal of implants.