带螺钉钢缆内固定联合中药熏蒸治疗髌骨骨折的临床疗效及对膝关节功能恢复的影响

Treatment of patellar fracture with screw and cable internal fixation combined with traditional Chinese medicine fumigation

目的探讨带螺钉钢缆内固定联合中药熏蒸治疗髌骨骨折的临床疗效及对膝关节功能恢复的影响。方法选取需手术治疗的髌骨骨折患者40例,随机分为对照组(n=20)和观察组(n=20),对照组进行克氏针张力带钢丝固定治疗,观察组行带螺钉钢缆内固定术后给予自拟中药进行熏蒸治疗2周。分析比较两组患者的膝关节肿胀和疼痛消失时间、并发症发生情况、术后3个月膝关节活动度及术后6个月膝关节功能。结果两组均顺利完成手术,对照组术后膝关节肿胀时间为(6.89±1.87)d,疼痛时间为(8.09±2.03)d,观察组分别为(5.27±1.45)d和(5.21±1.83)d,观察组术后膝关节肿胀及疼痛时间显著低于对照组,差异有统计学意义(P<0.05);对照组总并发症发生率为20.00%(4/20),显著高于观察组5.00%(1/20),差异有统计学意义(P<0.05);术后3个月观察组活动度明显优于对照组(P<0.05);术后6个月观察组膝关节优良率为100.00%(20/20),显著高于对照组80.00%(16/20),且差异有统计学意义(P<0.05)。结论带螺钉钢缆内固定联合中药熏蒸治疗髌骨骨折疗效确切,与传统克氏针张力带钢丝固定比较,可提高患者远期膝关节功能,降低并发症发生率。

Objective To investigate the clinical effect of the treatment of patellar fracture with screw internal fixation and traditional Chinese medicine fumigation,and the effect on the recovery of knee joint function.Methods 40 patients in our hospital from September 2015 to January 2017 and the need for surgical treatment of patellar fracture,were randomly divided into control group （n = 20） and observation group （n = 20）,the control group of Kirschner wire fixation for the treatment of fractures,the observation group underwent internal fixation with screw wire at the same time after fumigation with traditional Chinese medicine for 2 weeks.The knee swelling and pain disappearance time,complications,knee mobility in 3 months and knee function after 6 months were analyzed and compared between the two groups.Results Patients were successfully completed the operation,the control group of postoperative knee swelling time was （6.89 ± 1.87） d days,pain time was （8.09 ± 2.03） days D,the observation group postoperative swelling time was （5.27 ± 1.45） D and （5.21 ± 1.83） days,the observation group postoperative knee joint swelling and pain was significantly lower than the control group,and the difference was statistically significant difference （P〈0.05）; the control group the total complication rate was 20% （4/20） was significantly higher than the observation group 5% （1/20）,the difference was statistically significant （P〈0.05）; 3 months after the operation of the observation group was significantly better than the control group （P〈0.05）; 6 months after surgery,the observation group of knee joint excellent rate was 100% （20/20）,significantly higher than80% （16/20） in the control group,and the difference was statistically significant difference （P〈0.05）.Conclusion Screw wire internal fixation combined with traditional Chinese medicine fumigation treatment of patellar fractures,wire fixation compared with traditional Kirschner wire tension belt,which can improve the patients＇ long-term knee function,reduce the incidence of complications,it is worthy of popularization and application.