三种内固定法治疗髌骨骨折临床探讨

Clinical Study on Treatment of Patellar Fracture by Three Kinds of Fixation Methods

目的:探讨克氏针钢丝张力带、环形钢丝8字张力带及记忆合金聚髌器内固定治疗髌骨骨折的临床疗效。方法:回顾性分析江苏省仪征市中医院收治的髌骨骨折98例临床资料,将其分为横断型髌骨骨折组(横断组)和粉碎型髌骨骨折组(粉碎组)。横断组中分别采用了克氏针钢丝张力带和镍钛记忆合金聚髌器内固定法;而粉碎组中分别采用了环形钢丝8字张力带和镍钛记忆合金聚髌器内固定法。组内分别在合并并发症,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评分系统等方面进行比较分析。结果:横断组中,克氏针钢丝张力带内固定法和镍钛记忆合金聚髌器内固定法有统计学差异(P<0.05);粉碎组中,环形钢丝8字张力带内固定法和镍钛记忆合金聚髌器内固定法有统计学差异(P<0.05)。结论:镍钛记忆合金聚髌器组和其他两种内固定法相比,有明显的优势,值得临床推广。

Objective：To compare the curative effect among using Kirschner wire and tension band,8 characters of the ring wire tension band and Nitinol patellar concentrator. Methods：Retrospective analysis of patella fracture Yizheng City, Jian- gsu Province Hospital of Traditional Chinese Medicine treated 98 cases of clinical information, and divided them into a trans- verse patella fracture group （transection group） and comminuted patella fracture group （crush group）. In the transverse patel- la fracture group, we choose the fixation with Kirschner wire and tension band or Nitinol patellar concentrator. In the comminu- ted patella fracture group,we choose the fixation with 8 characters of the ring wire tension band or Nitinol patellar concentra- tor. In each group, the two different methods were compared in the incidence of complications, postoperationpain scores of starting exercse,the Lysholm score systerm was was used to asses the knee joint function in 1 month, 3month, 6month, 1 year. Results：In the transverse patella fracture group, the fixation with Nitinol patellar concentrator had statistical signifi- cance compared with Kirschner wire and tension band （ p 〈 0. 05 ）, and in the comminuted patella fracture group,, the fixation with Nitinol patellar concentrator had statistical significance compared with 8 characters of the ring wire tension band （ p 〈 0. 05 ）. Conclusion： The Method of using Nitinol patellar concentrator have significant advantages compared with the other two Methods, and are Worth of clinical.