三种术式治疗套袖状髌骨上极骨折的疗效分析

Analysis on the Curative Effect of Three Different Surgical Methods for the Treatment of Patellar Sleeve Fractures of the Upper Pole

目的探讨套袖状髌骨上极骨折治疗的理想手术方式。方法选取2011年6月至2014年6月期间我院接收的84例髌骨上极骨折患者,将入选者根据手术方式不同分为张力带组(Krackow法缝合编织股四头肌腱并"8"字张力带钢丝固定法,n=28)、缝合组(采用Krackow法缝合编织股四头肌腱固定法,n=28)、聚髌器组(聚髌器固定法,n=28),观察三组治疗疗效、手术情况及膝关节功能评分情况。结果术后6个月时,张力带组临床优良率显著高于缝合组、聚髌器组(P<0.05);术后6个月时,张力带组膝关节功能评分明显高于其他两组(P<0.05)。结论套袖状髌骨上极骨折采用Krackow法缝合编织股四头肌腱并"8"字张力带钢丝固定法治疗,疗效显著,可快速恢复病人患肢功能,具有推广价值。

Objective To investigate the ideal operation mode for patellar sleeve fractures of the upper pole. Methods There were 84 cases of patellar fracture patients from June 2011 to June 2014 admitted in our hospital who were divided into tension band group（ Krackow suture woven quadriceps tendon combined with ＂ 8＂ tension band wire fixation,n = 28）,suture group（ using Krackow suture woven femoral quadriceps tendon fixation,n = 28）,and patella concentrator group（ using patella concentrator,n = 28） according to the operation approaches. Treatment efficacy,surgical indexes and knee function scores of the three groups were compared. Results Six months after surgery,the clinical good rate of tension band group was significantly higher than that of the suture group and the patella concentrator group（ P 〈 0. 05）,and the knee joint function scores of tension band group were significantly higher than that of the other two groups（ P 〈 0. 05）. Conclusion It has obvious curative effect of the Krackow suture woven quadriceps tendon combined with ＂ 8＂ tension band wire fixation for the patients with sleeve patellar pole fractures,and can quickly restore the patients’ limb function.It is worthy of popularization.