关节镜辅助下微创内固定治疗髌骨骨折及修补股四头肌扩张部

Treatment of patellar fracture and retinaculum tear under arthroscopy

目的探讨关节镜辅助下微创内固定治疗髌骨骨折的临床效果及股四头肌扩张部修补方法。方法关节镜辅助下微创内固定治疗56例髌骨骨折。1例RockwoodⅡ型骨折采用空心钉内固定,其余Ⅱ-Ⅵ型骨折采用微创法置入Cable-pin或克氏针张力带内固定;应用"推移窗口"结合由外向内缝合技术修补损伤的股四头肌扩张部,一期处理半月板及软骨面损伤。结果 51例获得6-24个月随访。术后3个月X线片显示骨折均愈合,Bostman评分:优38例,良10例,差3例。术后6个月Bostman评分:优42例,良7例,差2例。结论关节镜辅助下可以治疗多种类型髌骨骨折,能早期发现并处理关节内附属结构损伤。应用"推移窗口"结合由外向内缝合技术,能较好修复受损股四头肌扩张部。

Objective To investigate minimally invasive technique in treating patellar fracture and retinaculum tear under arthroscopy. Methods Fifty six closed patellar fractures were treated with arthroscopy. One ease of Rockwood＇s Type II fracture was treated with eannulated screw fixation, the others were operated with minimally invasive technique using Cable- pin or K-wire and tension band. PateUar tears were also treated under arthroseopy. Results Fifty one patients were followed up for 6-24 months. All X rays showed healed fracture 3 months after operation. Bostman score： 38 excellent, 10 good and 3 bad. After 6 months, the Bostman score： 42-excellent, 7 good and 2 bad. Conclusion Treatment of patellar fracture under arthroseopy can achieve precise reduction and internal fixation of fracture, early discovery and treatment of other joint structure injury. Various type of patellar fracture can be well handled by different internal fixation instrument. The sliding window technique can treat retinaculum tear cutaneously.