骨科导向复位钳的研制及在髌骨骨折中的初步临床应用

Development of Orthopaedics-oriented Reduction Forcep and Initial Clinical Application in the Patellar Fracture

目的探讨骨科导向复位钳的研制及在髌骨骨折中的初步临床应用效果。方法方便选取2012年2月—2016年6月,该院收治的92例髌骨骨折患者,按照奇偶数字法均分为骨科导向复位钳组(A组)与点式复位钳组(B组),各46例。两组均采用胥氏改良张力带钢丝固定法固定,粉碎性骨折加用环形钢丝结合张力带固定。A组采用骨科导向复位钳加压复位减少骨折间隙、引导克氏针置入。B组则采用点式复位钳复位,不借助任何定位导向置入克氏针。观察手术时间、克氏针首次置入位置、置入次数、透视次数、遗留的骨折端间隙,并依Bostman评分标准对膝关节功能进行评估。结果骨科导向复位钳组临床优良:46/46(优良率100.00%),显著高于点式复位钳组优良:42/46(优良率91.30%),(P=0.04)。(2)两组间手术时间、穿针次数及术中透视次数差异有统计学意义(P<0.05);两者间首次置钉合格和遗留间隙例数差异有统计学意义(P<0.05)。结论骨科导向复位钳在髌骨骨折患者手术治疗中的应用效果显著,应加以推广及应用。

Objective To discuss the development of orthopaedics-oriented reduction forcep and initial clinical application in the patellar fracture. Methods Convenient selection 92 cases of patients with patellar fracture admitted and treated in the department of orthopaedics from February 2012 to June 2016 were selected and divided into two groups with 46 cases in each, both groups adopted the modified tension band steel wire for fixation, the group A adopted the orthopaedics-oriented reduction forcep to reduce the fracture gap, the group B adopted the dotteed reduction forcep for Kirschner wire placement without the aid of any orientation, and the operation time, first placement site of Kirschner, placement time were observed and the knee joint function was evaluated according to the Bostman evaluation criteria. Results The excellent and good rate of orthopaedics-oriented reduction forcep was obviously higher than the dotted reduction forcep,[100.00%（46/46） vs 91.30（42/46）]（P=0.04）. The differences in the operation time, pinning frequency and intraoperative perspectivity frequency had statistical significance（P〈0.05）, and the differences in the qualified rate of first screw placement and gap case had statistical significance（P〈0.05）. Conclusion The application effect of orthopaedics-oriented reduction forcep in the operative treatment of patients with patellar fracture is obvious, which can be promoted and applied.