关节镜下经皮螺丝钉内固定治疗髌骨骨折14例

Arthroscopically assisted percutaneous screw fixation for 14 cases of patellar fractures

目的探讨膝关节镜下螺丝钉内固定治疗髌骨骨折的疗效.方法 2001年11月～2004年6月我院在膝关节镜下对14例髌骨骨折经皮行髌骨骨折复位螺丝钉内固定术治疗14例髌骨骨折.先用手法挤压髌骨或经皮钻入克氏针撬拔协助复位, 大布巾钳抓持或克氏针临时固定, 膝关节镜观察或C形臂X机透视髌骨复位情况,并做适当调整,在进钉处做小切口,钻孔、测深、攻丝,平行打入2枚钛螺丝钉或可吸收螺丝钉.结果 13例随访6～18个月,平均10个月.术后膝关节功能恢复良好,根据胥少汀评分法,优11例(84.6%),良2例(15.4%).结论关节镜下经皮螺丝钉内固定治疗髌骨骨折创伤小,复位确切,固定可靠, 关节功能恢复好.

Objective To evaluate the effectiveness of arthroscopically assisted percutaneous screw fixation for treating patella fractures. Methods A total of 14 cases of patella fractures were treated by percutaneous reduction and internal fixation with screws under arthroscope from November 2001 to June 2004 in this hospital. The fracture was reduced by closed manipulation or percutaneous leverage force using the Kirschner wire. Then the patella was temporarily fixed by using a large - sized towel clamp or Kirschner wires. Under the guidance of knee arthroscopy or C - arm fluoroscopy, a micro - incision was made at the site of screw placement, the pilot holes were drilled at a proper depth, and the thread was configured. Two titanium screws or absorbable screws were inserted parallelly. Results Follow- up checkups for 6 - 18 months （mean, 10 months） in 13 cases showed a satisfactory recovery of knee functions, According to the Xu Shaoding＇ s standard, excellent effects were obtained in 11 cases （84.6%） and good effects, 2 cases （15.4%）. Conclusions Treatment of patellar fractures by percutaneous screw fixation under arthroscope offers advantages of minimal invasion, accurate reduction, reliable fixation, and excellent recovery of joint functions.