三维捆扎复位技术在髌骨骨折治疗中的初步应用研究

Clinical study of three-dimensional strapping reduction in treatment of patellar fracture

目的介绍一种三维捆扎复位技术,探讨其用于髌骨骨折治疗的疗效。方法将2015年1月—6月收治并符合选择标准的32例髌骨骨折患者纳入研究,随机分为巾钳复位组(对照组)和三维捆扎复位组(试验组),每组16例。两组患者性别、年龄、损伤侧别、致伤原因、骨折类型以及受伤至手术时间等一般资料比较,差异均无统计学意义(P>0.05)。记录两组患者手术时间、术中透视时间、骨折愈合时间及并发症发生情况,采用美国特种外科医院(HSS)评分评价膝关节功能。结果术后两组切口均Ⅰ期愈合。两组患者均获随访,随访时间10~14个月,平均12.4个月。试验组手术时间、术中透视时间较对照组明显减少,比较差异均有统计学意义(t=6.212,P=0.000;t=6.585,P=0.000)。X线片复查示,两组骨折均顺利愈合,均未出现骨不连、感染和断钉等并发症。两组骨折愈合时间比较差异无统计学意义(t=1.973,P=0.058)。术后6个月试验组膝关节HSS评分为(91.6±3.8)分,明显高于对照组的(86.4±5.5)分,比较差异有统计学意义(t=–3.105,P=0.004)。结论与传统巾钳复位技术相比,三维捆扎复位技术治疗髌骨骨折能够缩短手术时间及术中透视时间,在不影响骨折愈合情况下,膝关节功能恢复更好。

Objective To investigate the effectiveness of three-dimensional strapping reduction in treatment of patellar fracture. Methods Between January 2015 and June 2015, thirty-two patients were randomly allocated to three- dimensional strapping reduction group （trial group） and towel clamp reduction group （control group）. There was no significant difference in age, gender, damage side, interval from injury to opreration, fracture pattern, and cause of injury （P〉0.05）. The operation time, fluoroscopy time, fracture healing time, postoperative Hospital for Special Surgery （HSS） scores, and complications were collected and analysed. Results All incisions healed at stage I. All patients of 2 groups were followed up 10-14 months （mean, 12.4 months）. The operation time and fluoroscopy time of trial group were both shorter than those of control group （t=6.212, P=0.000; t=6.585, P=0.000）. X-ray films showed that the fractures in both groups healed successfully and there was no significant difference in healing time between groups （t=1.973, P=0.058）. Bone nonunion, infection, and failure fixation were not found in both groups. HSS scores of trial group （91.6±3.8） was higher than that of control group （86.4±5.5） （t=-3.105, P=0.004）. Conclusion Compared with towel clamp reduction, the three-dimensional strapping reduction in treatment of patellar fracture has the advantages of shorter operation time and fluoroscopy time, better knee function after operation, and satisfactory fracture healing.