关节镜及C型臂X线机辅助经皮空心螺钉内固定治疗髌骨骨折临床观察

Clinical observation on arthroscope and C-arm X-ray machine assisted percutaneous cannulated screw fixation of patellar fractures

目的：探讨膝关节镜及C型臂X线机辅助下经皮空心螺钉内固定治疗髌骨骨折的疗效。方法：本组26例,先用手法挤压髌骨或经皮钻入克氏针撬拨协助复位,大布巾钳抓持或克氏针临时固定,膝关节镜下观察及C型臂X线机透视髌骨复位情况和克式针置入位置,并做适当调整,在进钉处做小切口,钻孔、测深、攻丝,平行打入两枚钛空心螺钉。结果：术后随访6~13个月,优20例（76﹒92%）、良5例（19﹒23%）、可1例（3﹒84%）。结论：关节镜及C型臂X线机辅助下经皮空心螺钉内固定治疗髌骨骨折创伤小、出血少、副损伤少、复位确切、关节活动早、功能恢复快、治疗经费少,而且还可同时治疗膝关节内其他合并损伤。

Objective：To study the efficacy of arthroscopy and C-arm X-ray machine assisted percutaneous cannulated screw fixation of patellar fractures.Methods：Arthroscopic and C-arm X-ray machine assisted reduction and percutaneous cannulated screw fixation of patellar fractures were performed in 26 cases.First,the squeeze technique was adopted to drill into the patella or percutaneous Kirschner wire was used to help reset,using large linen grasping forceps or temporary Kirschner wire fixation.Arthroscopic observation and C-arm X-ray machine perspective patella reset conditions were performed.G-type needle was placed into position with appropriate adjustments,making a small incision in nail entering site,drilling,sounding,tapping and parallelly entering 2 titanium screws.Results：The patients were followed up for 6-13 months,excellent in 20 cases（76.92%）,good in 5 cases（19.23%）,fair in 1 case（3.84%）.Conclusion：Arthroscopic and C-arm X-ray machine assisted percutaneous cannulated screw fixation of patellar fracture trauma has less bleeding,less assistant damages,exact reduction,early joint activities,rapid rehabilitation,low cost,and simultaneously treats other complicating injuries in knee joint.