关节镜微创与切开复位内固定治疗髌骨横形骨折比较

Curative effect of minimally invasive arthroscopic surgery versus open reduction and internal fixation for transverse patellar fractures

目的:探讨关节镜直视下经皮空心钉张力带内固定术治疗髌骨横形骨折的疗效。方法:分析我院2012年1月至2016年5月收治的57例髌骨横形骨折的患者,按手术方式分为关节镜组30例与常规手术组27例,关节镜组在关节镜直视下行经皮空心钉张力带内固定术,常规组行手术切开空心钉张力带内固定术,比较两组术后疼痛视觉模拟(VAS)评分情况、骨折愈合情况及膝关节功能。结果:57例患者均获得6~18个月的随访,关节镜组较常规组术后VAS评分明显降低,骨折愈合时间短,膝关节功能恢复好,差异均有统计学意义(P<0.05)。结论:关节镜直视下行闭合复位髌骨骨折空心钉张力带内固定术,关节面复位良好,骨折愈合快,创伤小、固定牢固,术后患者膝关节功能恢复良好。

Objective To investigate the clinical efficacy of percutaneous cannulated screwand arthroscopy in the treatment of transverse patellar fractures. Metliods ： 57 cases of transverse patellar fractures from May 2016 were divided into arthroscopic group （30 cases） and conventional surgery group （27 cases） according to the surgicalmode. The arthroscopy group underwent percutaneous cannulated screw and tension band fixation under arthroscopy while theconventional surgery group underwent open reduction plus cannulated screws and tension band fixatiovisual analogue scale （ VAS）,the fracture healing and knee joint function were compared between the two grouppatients were followed up for 6-18 months; the arthroscopic group showed significantly lower VAS score,shorter healing time,better knee joint function than the conventional surgery grou p （ P 〈0. 0 5 ） . Conclusion： Closed reduction combined with cannulated screwand tension band fixation under arthroscopy for transverse patellar fracture can achieve good joint surface reduction, fast healing time,small injury,firm fixation,and good postoperative recovery of knee joint function.