“AO”张力带治疗RockwoodⅡ、Ⅲ型髌骨骨折的临床疗效对比

The Clinical Curative Effect Comparison of "AO" Tension Band in the Treatment for Patellar Fractures of Rockwood Ⅱ and Ⅲ

目的观察和评价分析"AO"张力带原理的不同治疗方法在RockwoodⅡ、Ⅲ型髌骨骨折治疗中的疗效。方法选取我院2013年10月至2017年10月期间住院并且接受手术治疗的100例RockwoodⅡ、Ⅲ型髌骨骨折患者作为研究对象,按非完全随机方法将其分为观察A组、观察B组和对照C组、对照D组,观察A组采用钢缆和带孔克氏针"8"字捆绑固定,观察B组采用钢缆和带孔克氏针"0"字捆绑固定;对照C组采用普通克氏针、钢丝"8"字捆绑固定,对照D组采用普通克氏针、钢丝"0"字捆绑固定,比较各组间患者术后半年膝关节活动功能、骨折愈合情况及并发症发生率。结果所有研究对象均获得随访,观察A、B组与对照C、D组之间两两组间比较,膝关节活动度及髌骨骨折愈合时间未见显著差异(P>0. 05),对照组术后并发症发生率高于观察组,差异具有统计学意义(P <0. 05)。结论普通克氏针、钢丝张力带与带孔克氏针、钢缆张力带内固定术操作简单,学习曲线短,均能很好地治愈RockwoodⅡ、Ⅲ型髌骨骨折,效果良好,而且带孔克氏针、钢缆张力带术后并发症更少,适合在基层医院推广使用。

Objective To evaluate and analyze the efficacy of different treatments of ＂AO＂ tension band for patella fractures of Rockwood Ⅱ and Ⅲ. Methods There were 100 cases with Rockwood Ⅱ and Ⅲ patellar fractures were enrolled in this study in our hospital during October 2013 to October 2017. They were incompletely randomly divided into group A （the observation group）, group B （the observation group）, group C （the control group）, and group D （the control group）. Group A was treated with a ＂8＂ steel cable and perforated Kirschner and group B was treated with a ＂0＂ steel cable and perforated Kirschner. Group C was treated with an ＂8＂ steel wire and Kirschner wire and group D was treated with a ＂0＂ steel wire and Kirschner wire. The function of knee joint activity, fracture healing time and the complication rate were compared among different groups. Results All the patients were followed up. There was no significant difference in knee activity function and patella fracture healing time（ P 〉0.05）. The incidence of postoperative complications in the control groups were higher than that in the observation groups, and the differences were statistically significant（ P 〈0.05）. Conclusions The inner fixations of common Kirschner wires, steel wire tension bands, perforated Kirschner wires, and the steel cable all have advantages of simple procedure and short learning curve, which can be used for Rockwood Ⅱ and Ⅲ patellar fractures with good effect. Moreover, there are fewer complications after the operation of perforated Kirschner wire and steel cable, which is suitable for the promotion in the primary hospitals.