髌骨骨折3种手术方法的临床比较

Comparison of Three Internal Fixation Methods in Treating Patella Fractures

目的:比较钢丝张力带、空心螺钉固定、空心螺钉张力带3种不同内固定方法治疗横行髌骨骨折的疗效。方法:2007年4月～2009年4月采用钢丝张力带固定(TB)23例,空心螺钉张力带(CSTB)19例。比较3种手术在手术时间,手术切口长度,手术中止血带时间,术中出血,术后功能锻炼开始时间,术后锻炼Oswestry疼痛功能评分,术后1个月,3个月,6个月,1年的Lysholm评分系统评行比较分析。结果:所有病例跟踪调查15个月,在手术时间、手术中止带时间3组未见统计学差异(P>0.05)。在手术切口长度TB组和CS组、CSTB组有统计学差异(P<0.05)。在术后功能锻炼开始时间,术后锻炼疼痛评分,术后1个月,3个月,6个月,1年的膝关节功能评分CS组和TB组、CSTB组有统计学差异(P<0.05),而TB组和CSTB组无统计学差异(P>0.05)。结论:空心螺钉张力带组和其他2组相比,有明显的优势。可以考虑作为髌骨骨折的常规手术方法。

Objective：To compare the curative effect among using tension band fixation,canulated screw fixation and canulated screw with tension band.Methods：From 2007.4 to 2009.4,tension band fixation was used in 23 cases,canulated screw fixation was used in 17 cases,canulated screw with tension band was in 19 cases.The three gruoups were compared in the time of operation,length of incision,time of using tourniquet,intro-operation bolld loss,postoperation time of starting exercise,postoperation pain scores of starting exercse,the Lysholm score systerm was was used to asses the knee joint function in 1 month,3month,6month,1year.Results：All cases were followed up for 15 months,the three groups had no statistical significance in time of operation and time of using tourniquet,（p〉0.05）TB group had statistical significance in length of incision compared with CS group and CSTB group（P〈0.05）.CS group had statistical significance in postoperation time of starting exercise,postoperation pain scores of starting exercise,KJF scores compared with TB group and CSTB group（p〈0.05）,but CS group and CSTB group had no statistical significanc（p〉0.05）.Conclusion：The Method of using canulated screw with tension band might have significant advantages compared with the other two Methods.This Method may be the roution Method in treating the patella fractures.