缝合复位治疗髌骨粉碎骨折效果分析

Stitching Reset for the Treatment of Comminuted Fracture of Patella

探讨缝合复位技术治疗髌骨粉碎骨折的临床疗效。自2005年3月至2011年7月应用髌骨骨折片缝合复位的方法配合内固定器械固定治疗髌骨粉碎骨折患者共24例。男13例，女11例；年龄23岁～62岁，平均42．2岁。1例为开放性髌骨粉碎骨折，其余为闭合性髌骨粉碎骨折。1例开放骨折采用横切口，其余采用纵直切口。暴露髌骨骨折后，用可吸收缝线紧密缝合骨折片，缝合的同时骨折得到复位及固定，后加用其他内固定器械加强固定。术后早期开始屈伸膝关节功能锻炼。结果24例患者术后均获得随访，随访时间8个月～24个月，平均13．4个月。8周随访均达到临床愈合，2个月～3个月（平均2．8个月）骨性愈合，无并发症发生。采用Bostman评分方法评定疗效：优21例，良3例，优良率100%。因此采用缝合复住技术治疗髌骨粉碎骨折，具有操作简便、手术时间短及关节面复位固定好等优点；配合内固定器械固定，使粉碎骨折复住后固定更稳定，术后可以早期功能锻炼，疗效确切。

To investigate the clinical efficacy of stitching reset treatment of comminuted fracture of patella reduction techniques. 24 cases of comminuted fracture of patella were treated by stitching reset with concentrator from March 2005 to July 2011. The demography of 24 cases was as follows： 13 male and 11 female,the age from 23 to 62 years old （the mean average is 42. 2 years old）. One case was open comminuted fracture of patella, and the rest were closed patella fracture. One case used the transverse incision for open fractures, and the rest were all vertical straight incision. After exposure of patella fracture, tight suture with absorbable sutures fractures sheet should be used firstly, at the same time fracture can be of restoration and fixation, and then used the further internal fixation devices to strengthen fixation. Postoperative knee functional exercise of flexion and extension was taken early. 24 cases of patients received the postoperative follow-up visit, the visit time varied from 8 to 24 months, and the average time is 13.4 months. 8 weeks follow-up have achieved the clinical healing, 2 to 3 months （the mean is 2.8 months） have healed without complications. Bostman score method was used to assess efficacy, with the results showed that 21 cases were excellent, 3 cases were good and the excellent and good rate was 100%. Using stitching reset in the treatment of comminuted fracture of patella has the advantages of simple operation, short operation time and good fixation of the articular surface. Cooperating with internal fixation devices can make the postoperative restoration and fixation more stable, and postoperative function exercise can be taken early and have the curative effect.