克氏针钢缆内固定在髌骨骨折治疗中的应用

Application of internal fixation with Kirschner's Nails Cable in the treatment of patella fracture

目的探讨克氏针钢缆内固定治疗髌骨骨折的临床疗效。方法利用克氏针钢缆内固定选择性治疗40例闭合性髌骨骨折患者,骨折复位后,垂直骨折线或主要骨折块选择两枚直径2.0～2.5mm克氏针分别自髌骨上缘平行钻入髌骨,经骨折端穿出髌骨下极,再使用钢缆分别绕过克氏针的上下针尖,在髌骨前方"8"字结扎,用专用器械收紧钢缆,以专用束缚器将钢缆固定,15例粉碎性髌骨骨折,全部于髌骨外侧环扎。结果本组40例患者随访9～15个月,平均12个月。骨折全部愈合,无退钉、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34例,良6例,优良率为100%。结论克氏针钢缆固定治疗髌骨骨折,具有固定牢固可靠、合并症少、性价比高、患者容易接受、可以早期功能锻炼的优点,是治疗髌骨骨折的一种良好方法。

Objective To study the effects of internal fixation with Kirschner＇s Nails Cable in the treatment of patellar fractures.Methods Forty patients of patellar fracture were treated by internal fixation with Kirschner＇s Nails Cable. After reduction, the vertical fracture line or the main fracture block were drilled parallel by 2 Kirschner wires （2.0～2.5 mm in diameter） from the upper edge of the patella into the patella, through the fracture to the patella pole. And then the cable was used to bypass the upper and lower tip of the Kirschner wires, the cable was crossed in a the shape of ＂8＂ over the anterior surface of the patella. Then the cable was tightened and fixed. The 15 cases of comminuted patella fracture all underwent cerclage in the lateral of patella. Results The 40 patients were followed up for 9～15 months （12 months in average）. Fractures healed in all the patients without such complications as loosening of Kirschner wire and cable loop, loss of reduction or irritation to soft tissue. Restoration of the knee joint motion was excellent in 34 cases and good in 6 cases according to Bostman score system, with the excellent and good rate of 100%. Conclusion Internal fixation with Kirschner＇s Nails Cable is effective in the treatment of patella fracture with reliable fixation, less complication, which is cost-effective and easy to be accepted by patients.