镍钛聚髌器结合可吸收线缝扎治疗髌骨粉碎性骨折

Treatment of comminuted patellar fractures with absorbable suture and NT-PC-concentrator

背景:镍钛聚髌器结合可吸收线缝扎置入内固定治疗髌骨粉碎性骨折,可避免骨折块移位情况。目的:探讨镍钛聚髌器结合可吸收线缝扎置入治疗髌骨粉碎性骨折的临床疗效。方法:纳入53例患者,根据AO分型:B3型8例,C2、C3型45例。其中男37例,女16例:年龄17～72岁,平均36.8岁。观察可吸收线缝扎结合镍钛聚髌器治疗髌骨粉碎性骨折的临床疗效。结果与结论:53例中失访15例,38例患者骨折愈合时间2～4个月,无内固定物松动、断裂及再骨折发生,置入后发生切口表浅感染3例,膝关节滑膜炎2例,原有骨性关节炎一过性加重1例。按Lysholm & Gillquist膝关节评分标准,优30例,良6例,可2例,优良率94.7%。提示,镍钛聚髌器具有"动力性张力带作用"可以复位及固定髌骨骨折,结合可吸收线缝扎治疗髌骨粉碎性骨折具有较好的生物力学性能,能使骨折块紧密接触,固定可靠。

BACKGROUND：NT-PC-concentrator combined with absorbable suture can avoid displacement of fracture fragments in the internal fixation of patella fracture.OBJECTIVE：To investigate the clinical effects of stabilizing comminuted patellar fractures with internal fixation by absorbable suture with NT-PC-concentrator.METHODS：Fifty-three cases of fresh comminuted patellar fractures treated with internal fixation by absorbable suture with NT-PC-concentrator from October 2005 to December 2009.The demography of the 53 cases was as follow：37 males and 16 females,ranging from 17 to 72 years old（a mean of 36.8 years old）.According to AO classification,there were 8 cases of B3 an 45 cases of C2,C3.RESULTS AND CONCLUSION：Thirty-eight cases out of 53cases were followed up with a mean period of 8 months.All the 38 patients obtained bone union in 2-4 months.No case of implant loosening or refracture was found.Three cases of infected incision,2 cases of postoperative Knee synovitis,and 1 cases of temporary aggravation of pre-existing osteoarthritis were documented as postoperative complication.Of the 38 cases,30 cases were scored excellent under the LysholmGillquist score 6 good and 2 fair.The excellent and good rate was 94.7%.Absorable suture has better characteristics of mechanism in treating communited patellar fracture.It keeps fracture sites closely apposed and can fix bone fragments reliably.The NT-PC fixation is characteristics by a dynamic tension band mechanism.It serves the role of reduction and fixation simultaneously and can facilitate early postoperative range of motion exercises.