关节镜直视下经皮空芯螺钉内固定联合张力带治疗髌骨骨折

Arthroscopic treatment of patellar fracture by percutaneous hollow screw and tension band

目的 探讨关节镜下经皮空芯螺钉联合张力带内固定治疗髌骨骨折的疗效.方法 将40例髌骨骨折患者随机分为两组,采用关节镜监视下经皮空芯螺钉联合张力带治疗髌骨骨折17例（治疗组）,采用常规开放性手术治疗髌骨骨折23例（对照组）,于术后1、3、6、9、12个月进行随访,评价膝关节功能情况,并进行统计学分析.结果 治疗组同对照组膝关节功能比较无统计学意义（P＞0.05）,而治疗组同对照组在手术出血量、手术时间、住院时间的对比中有统计学意义（P＜0.05）.结论 关节镜直视下经皮空芯螺钉内固定联合张力带治疗髌骨骨折创伤小、出血量小、复位准确、关节活动早、功能恢复快,比较容易被患者接受,是现代医学的潮流.

Objective To evaluate the effectiveness of arthroscopic technique for patella fracture by percutaneous hollow screw and tension band. Methods From January 2010 to May 2013,17 cases of patella fracture were treated by percutaneous hollow screw and tension band under the arthroscope. The other 23 cases of patella fracture were treated by the traditional open surgery as controls. The cases were followed up at the 1 st,3rd,6th,9th, 12th months after operation. The recovery of knee joint was assessed for statistical analysis. Results There was no significant difference in knee joint function between the groups （P 〉 0.05 ） ; but there were significant differences in blood loss, operation time and hospital stay（ P 〈 0.05 ）. Conclusion In the treatment of patella fracture, the percutaneous hollow screw and tension band under the arthroscope has the advantages of minimal invasion, little blood loss, accurate restoration and early recovery. It can be easily accepted by the patients and conforms to the modem tide of medical development.