Cable—Pin系统在髌骨骨折治疗中的应用

Treatment of transverse patellar fractures with Cable-Pin system

目的探讨应用Cable—Pin系统内固定治疗髌骨骨折的临床疗效。方法2005年8月～2006年3月，利用Cable—Pin系统选择性治疗髌骨骨折32例，均为含有横断型的闭合性髌骨骨折患者。其中男23例，女9例；年龄24～75岁，平均45岁。切开复位后，纵行在髌骨关节面下尽可能平行拧入2根钢缆的螺丝钉部分（顺向或逆向），以使两个主要骨折块间获得纵向加压。然后在髌骨远端（或近端）横行钻一骨隧道，用钢缆穿过隧道，在髌骨前方“8”字结扎。用专用器械收紧钢缆，以专用固定夹扣将钢缆固定。如果骨折不够稳定可以将钢缆继续环绕髌骨，最后再用一个固定夹扣将钢缆固定。结果32例患者获得2—9个月随访，平均7个月。伤口均一期愈合，无感染发生。骨折全部愈合。无退针、钢缆松脱和皮肤刺激等并发症发生。以Bostman髌骨骨折疗效评分标准进行评分：优30例，良2例，优良率为100％。结论Cable—Pin系统对骨折固定牢固可靠，术后并发症发生率低，是治疗横断型髌骨骨折的一种理想新选择。

Objective To study the effects of Cable-Pin system used as a treatment alternative for transverse patellar fractures. Methods Thirty-two cases of patellar fracture were treated with the Cable-Pin system （Zimmer） in our department from August 2005 to March 2006. They were all transverse close fractures of patella. There were 23 males and 9 females. Their ages ranged from 24 to 75 years old （45 ys on average）. Two screws attached to the cable system were driven （in antegrade or retrograde direction） as longitudinally parallel as possibly into the patellar to exert longitudinal compression onto the two major fragments after open reduction. A transverse bone tunnel was then drilled at the distal or proximal part of the patella to pull through the cable which was legated in the figure of 8 in front of the patella and next tightened and fixated by special instruments. Results The 32 patients were followed up for 2 to 9 months （mean, 7 m） . Fractures healed in all the cases without such complications as loosening of screw and cable loop, loss of reduction or irritation to soft tissue. Restoration of the knee joint motion was excellent in 30 cases and good in 2 cases according to Bostman score system. Conclusion Cable-Pin system, as a new option for the treatment of transverse patella fracture, can result in reliable fixation and low rate of complications.