关节镜下经皮空心螺钉结合钢丝环扎治疗髌骨骨折的疗效

Curative Effect of Arthroscopic Percutaneous Cannulated Screw Fixation Combined Steel Wire Cerclage on Patellar Fracture

目的探讨关节镜下经皮空心螺钉结合钢丝环扎治疗髌骨骨折患者近、远期疗效。方法将100例髌骨骨折患者按随机数字表法分为关节镜组和切开组,每组50例。切开组给予切开复位治疗,关节镜组给予关节镜下经皮空心螺钉结合钢丝环扎治疗。比较2组手术切口长度、术中出血量、住院时间、骨折愈合时间与并发症发生情况,采用Lysholm膝关节评分法评估2组术后6、12个月膝关节功能。结果关节镜组切口长度、术中出血量、住院时间、骨折愈合时间及并发症发生率均较切开组明显减少,差异有统计学意义(P<0.05);关节镜组术后6个月Lysholm评分明显高于切开组,差异有统计学意义(P<0.05),2组术后12个月Lysholm评分比较差异无统计学意义(P>0.05)。结论与切开复位比较,关节镜下经皮空心螺钉结合钢丝环扎治疗髌骨骨折可有效减少患者手术创伤和并发症,有利于患者近期功能的恢复。

Objective To investigate the short-term and long-term effects of arthroscopic percutaneous cannulated screw fixation combined steel wire cerclage on patellar fracture.MethodsOne hundred patients with patellar fracture were randomly assigned to receive either open reduction therapy（open group,n=50）or arthroscopic percutaneous cannulated screw fixation combined steel wire cerclage（arthroscopic group,n=50）.Incision length,intraoperative blood loss,hospital stay,fracture healing time and complications were compared between the two groups.Knee joint function was evaluated using Lysholm score 6 and 12 months after operation.ResultsCompared with open group,the incision length,intraoperative blood loss,hospital stay,fracture healing time and incidence of complications decreased in arthroscopic group（P〈0.05）.Furthermore,the Lysholm score in arthroscopic group was higher than that in open group 6 months after operation（P〈 0.05）.There was no significant difference in Lysholm score between the two groups 12 months after operation（P〉0.05）.Conclusion Compared with open reduction,arthroscopic percutaneous cannulated screw fixation combined steel wire cerclage reduces surgical trauma and complications and is conducive to the recovery of short-term function in patients with patellar fracture.