高强度可吸收线缝合固定治疗粉碎性髌骨骨折临床疗效分析

Clinical Analysis on the High Strength Absorbable Suture Fixation for Comminuted Patella Fractures

目的探讨粉碎性髌骨骨折应用高强度可吸收线缝合固定的临床效果。方法选择2014年8月～2018年2月在我院诊治的粉碎性髌骨骨折患者58例,根据不同治疗方法分为两组:观察组30例,采用高强度可吸收线缝合固定治疗;对照组28例,予克氏针张力带固定治疗。结果所有患者均顺利完成手术,切口均一期愈合,均无感染、切口裂开及皮肤坏死。术前1 d两组Lysholm评分和Kujala评分比较,差异均无统计学意义(P>0.05);术后3个月两组Lysholm评分和Kujala评分均高于术前,且观察组高于对照组,差异均有统计学意义(P<0.05)。术后3个月观察组膝关节优良率高于对照组,差异有统计学意义(100.0%VS 85.7%,P<0.05)。术前1 d两组屈膝30°时的适合角和外侧髌股角CT测量值比较均无统计学差异(P>0.05),术后3个月均减小,观察组低于对照组,差异有统计学意义(P<0.05)。结论采用高强度可吸收缝线缝合固定治疗粉碎性髌骨骨折有利于促进膝关节功能的恢复,改善髌骨生物力学状态,有很好的应用价值。

Objective To investigate the clinical effects of the high strength absorbable suture fixation for comminuted patellar fractures. Method A total of 58 cases with comminuted patellar fractures were enrolled from August 2014 to February 2018, and were divided into the observation group(n=30) and the control group(n=28) treated with high intensity absorbable suture fixation and Kirschner tension band fixation respectively. Results All the surgical interventions accomplished successfully, and the incision healed without infection, dehiscence and skin necrosis. There was no significant difference in Lysholm score and kujala score between two groups 1 day before the operation(P>0.05). Both Lysholm score and Kujala score were higher in two groups at 3 months after the operation than those before the operation, and both were higher in the observation group than those in the control group after the surgery, and all the differences were statistically(P<0.05). There was statistical difference in the excellent and good rate of knee joint between the observation group and the control group after the surgery(100.0% VS 85.7%, P<0.05). Both the congruence angle and the lateral patellofemoral angle at 30° of knee flexion appeared no statistical difference between the two groups before the surgery, but 3 months after the operation both decreased significantly, and both were lower in the observation group than those in the control group with statistical differences(P<0.05). Conclusion The suturing fixation of high intensity absorbable suture can play an important role for treating the comminuted patellar fractures by promotion of the knee joint restoration and improve the biomechanical status of the patella.