切开复位克氏针张力带与闭合复位经皮空心钉内固定治疗髌骨骨折的疗效比较

Comparison of curative effect between open reduction Kirschner tension band and closed reduction percutaneous hollow screw internal fixation for patellar fractures

目的比较切开复位克氏针张力带与闭合复位经皮双头加压空心钉内固定治疗髌骨骨折的疗效。方法回顾性分析自2013-01—2016-01诊治的65例横形髌骨骨折,采用闭合复位经皮双头加压空心钉内固定治疗30例(空心钉组),采用切开复位克氏针张力带内固定治疗35例(张力带组)。比较2组术后0.5、3、6个月的VAS评分及膝关节功能Lysholm评分。结果 65例均获得随访6~12个月,平均8个月。张力带组2例出现克氏针松动退出刺激皮肤,取出内固定后缓解。空心钉组无内固定松动断裂及皮肤刺激等并发症。空心钉组术后0.5、3、6个月VAS评分均低于张力带组,空心钉组术后0.5、3、6个月膝关节功能Lysholm评分高于张力带组,差异有统计学意义(P<0.05)。结论闭合复位经皮空心钉内固定治疗髌骨骨折可取得满意的临床效果,术后患者可以获得良好的膝关节功能,且疼痛轻,并发症少。

Objective To compare curative effect of open reduction Kirschner tension band internal fixation and closed reduction percutaneous pressing hollow screw internal fixation for patellar fractures.Methods Sixty-five patients with patellar transverse fractures from January 2013 to January 2016 were treated：30 cases were treated by closed reduction percutaneous pressing hollow screw（hollow screw group） while 35 cases were treated by open reduction Kirschner tension band （tension band group）.The VAS scores and knee-joint function scores of the two groups 0.5,3 and 6 months after operation were compared.Results The 65 cases were followed up for 6-12 months and the average was 8 months.Two cases in tension band group had Kirschner pins losing out with skin irritation,and were relieved after taking out internal fixation.There was no wound infection,loosening or breakage of internal fixation and skin irritation in hollow screw group.The VAS scores in postoperative 0.5,3 and 6 months for hollow screw group were lower than tension band group.The Lysholm scores of postoperative 0.5,3,and 6 months for hollow screw group were higher than tension band group.The difference was statistically significant （P 〈0.05）.Conclusion Close reduction percutaneous pressing hollow screw internal fixation for patellar fractures can get good clinical results,and patients can get good knee-joint function,small postoperative pain and less complications.