可分离髌骨爪联合张力带保护钢丝治疗小儿髌骨骨折疗效分析

Curative effect analysis of separable patella claws and tension-band wire in the repair of children comminuted patellar fractures

目的分析比较可分离髌骨爪联合张力带保护钢丝与克氏针钢丝张力带对小儿髌骨粉碎性骨折的疗效及术后并发症情况。方法我院行手术治疗的小儿髌骨粉碎性骨折病人68例,随机分为观察组和对照组,每组34例。观察组予以可分离髌骨爪联合钢丝张力带固定,对照组予以克氏针钢丝张力带固定,出院后随访2年,比较两组病人手术时间、切口长度、骨折愈合时间、膝关节功能恢复评分及并发症发生率。结果两组手术时间[(51.54±4.13)分钟和(52.09±3.82)分钟]、切口长度[(6.92±0.12)cm和(6.93±0.14)cm]比较差异无统计学意义(P>0.05),观察组骨折愈合时间为(9.04±1.05)周,对照组为(10.88±0.92)周,观察组膝关节功能恢复评分优良率为91.18%,对照组为70.59%,观察组并发症发生率为2.94%,于对照组为20.59%,两组比较差异有统计学意义(P<0.05)。结论可分离髌骨爪联合张力带保护钢丝内固定可减少小儿髌骨粉碎性骨折愈合时间,膝关节功能恢复好,且术后并发症发生率低。

Objective To compare the curative effect and complications of separable patella claws and tension-band wire with Kirschner wire tension band in the repair of children comminuted patellar fractures. Methods A total of 68 children with comminuted patella fracture treated in our hospital from January 2012 to January 2015 were randomly selected and randomly assigned to observation group and control group,34 cases in each group. Observation group received separable patella claws and tensionband wire fixation. Control group received Kirschner wire tension band fixation. Operative time,incision length,fracture healing time,postoperative complications and Hospital for Special Surgery knee function scores were compared between the two groups. Results No significant difference in incision length[（51.54 ± 4. 13 vs 52.09 ± 3.82）min]and operative time[（6.92 ± 0.12 vs 6.93 ± 0.14）cm]was detected between the two groups（ P〈0.05）. Significant differences in healing time [（ 9.04 ± 1.05 vs10.88 ± 0.92） w],incidence of complications and The excellent and good rate of knee joint function treated in observation group（91.18%） was higher than control group（70.59%）,and the incidence of complications was lower than control group（ 2.94% vs 20.59%）,the difference was indicated significant（ all P〈0.05）. Conclusion Separable patella claws and tension-band wire in the repair of children comminuted patellar fractures has some advantages such as short healing time,good functional recovery of knee joint and less postoperative complications,has good prospects.