髌骨针+Polysorb可吸收线缝扎固定治疗髌骨粉碎性骨折的疗效分析

Clinic outcome of combined fixation with patellar needle and polysorb absorbable sutures in the treatment of patellar comminuted fracture

目的探讨髌骨针+Polysorb可吸收线缝扎固定治疗髌骨粉碎性骨折的技巧与疗效。方法采用髌骨针+Polysorb可吸收线缝扎固定治疗髌骨粉碎性骨折,共计86例,术中透视观察髌骨关节面的恢复情况,术后观察其固定的牢固程度、关节面平整程度、愈合情况及膝关节功能恢复程度。结果术中见所有病例的髌骨关节面均明显恢复,随访时间6～18个月,术后所有病例骨折均骨性愈合,膝关节屈伸功能锻炼良好。术后1年膝关节HSS评分为82～93分,平均为88分,按膝关节疗效判断标准其术后优良率达89.5%。经统计学分析,髌骨关节面恢复情况、HSS评分、疗效判断标准优良率,术前、术后差异有统计学意义(P<0.01),与健侧差异无统计学意义(P>0.05)。结论髌骨针+Polysorb可吸收线缝扎固定治疗髌骨粉碎性骨折,创伤小、固定可靠、复位满意、并发症少,是治疗髌骨粉碎性骨折的有效方法。

Objective To evaluate the surgical technique and clinical outcome of combined fixation with patellar needle and polysorb absorbable sutures in the treatment of patellar comminuted fracture.Methods 86 cases of patellar comminuted fractures were treated by combined fixation with patellar needle and polysorb absorbable sutures.The restoration of the articular surface was observed intra-operatively.The internal fixation,smoothing of the articular surface,bone healing and knee function recovery were evaluated post-operatively.Results The articular surface of all cases were satisfactorily restored intraoperatively.All of the cases were followed up to 6 to 18 months after the operation and bony union was obtained.Knee flexion and extension function was well.The HSS score of knee joint was 82 to 93 （88 in average）and the excellent and good ratio was up to 89.5% .Post-operatively,the differences of restoration of the articular surface,HSS scoring,clinical excellent and good ratio were statistically significant as compared with those before operation （P0.01）,but not different as compared with those of the opposite site （P0.05）.Conclusion Combined fixation with patellar needle and Polysorb absorbable sutures provides reliable fixation and satisfactory restoration,with less trauma and complication,which is an effective treatment method for patellar comminuted fracture.