空心加压螺钉联合钢丝张力带内固定微创治疗髌骨骨折的效果观察

Effect observation of hollow compression screw combined with tension band wire for internal fixation minimally invasive treating patella fracture

目的：探讨空心加压螺钉联合钢丝张力带内固定微创治疗髌骨骨折的临床效果。方法选取本院2010年6月-2014年6月收治的髌骨骨折患者60例，将患者分为观察组与对照组，每组30例。观察组采用空心加压螺钉联合钢丝张力带内固定微创治疗，对照组采用克氏针张力带治疗。比较两组的手术时间、术中出血量、骨折愈合时间，膝关节功能优良率等。结果观察组的术中出血量少于对照组（P〈0.05）；观察组的膝关节功能优良率为93.4%，明显高于对照组的70.0%，（P〈0.05）；观察组术后的VAS评分为（1.5±0.8）分，明显低于对照组的（2.8±1.2）分（t=2.945，P〈0.05）；随访中，观察组患者均未出现伤口感染、骨折断端再次移位、皮肤刺痛或切口未按期愈合等并发症，对照组患者有1例出现伤口感染，2例出现皮肤刺痛、克氏针松动，两组的并发症发生情况差异有统计学意义（P〈0.05）。结论空心加压螺钉张力带钢丝内固定治疗髌骨骨折具有较好的生物力学特性，且并发症少，值得临床推广。

Objective To investigate the clinical effect of hollow compression screws combined with tension band wire for internal fixation minimally treating patella fracture. Methods 60 patients with patella fracture treated in our hospital from June 2010 to June 2014 were selected and they were divided into observation group and control group,and there were 30 cases in each group.Observation group was treated with hollow compression screw combined with tension band wire for internal fixation minimally invasive treatment,while control group was treated with Kirschner wire tension band. Operation time,bleeding amount during operation,the time of fracture healing,excellent and good rate of function of knee joint and so on between two groups were compared. Results Bleeding amount during operation of observation group was fewer than those of control group （P〈0.05）;excellent and good rate of function of knee joint of observation group （93.4%） was higher than that of control group （70.0%） （P〈0.05）;VAS score after operation of observation group [（1.5±0.8） points] was lower than that of control group [ （2.8±1.2） points] （t=2.945,P〈0.05）;at follow-up,patients in observation group was no wound infection,broken end of the fracture shifted once again,skin irritation or incision not healed on schedule and other complications,there was 1 cases with wound infection,2 cases with skin irritation and loosening of Kirschner wire and there was a statistical difference of complication between two groups （P〈0.05）. Conclusion Hollow compression screw combined with tension band wire for internal fixation minimally invasive treating patella fracture has better biomechanical properties with fewer complications,and it is worthy of clinical promotion.