开放与闭合复位张力带治疗AO Ⅲ型髌骨粉碎性骨折的疗效比较

Comparison of clinical efficacy between open and closed reduction tension band in the treatment of AO Ⅲ type comminuted patellar fracture

目的比较开放与闭合复位张力带治疗AOⅢ型髌骨粉碎性骨折的临床疗效。方法将2013年5月至2018年5月云浮市人民医院收治的80例AOⅢ型髌骨粉碎性骨折患者随机分为开放组和闭合组,每组40例。开放组予开放复位张力带内固定治疗,闭合组予闭合复位张力带内固定治疗,所有患者均进行术后6个月的跟踪随访,比较两组患者临床疗效的差异。结果闭合组患者手术时间、术中出血量、切口长度、住院时间、骨折愈合时间及术后并发症发生率均明显少于开放组,术后2周,1、3、6个月美国特种外科医院(HSS)膝关节评分均明显高于开放组(P<0.05)。结论与开放术式比较,闭合复位张力带内固定治疗AOⅢ型髌骨粉碎性骨折创伤小,骨折愈合快,膝关节功能恢复良好,术后并发症发生率低,短期疗效显著。

Objective To compare the clinical efficacy between open and closed reduction tension band in the treatment of AOⅢtype comminuted patellar fracture.Methods Eighty patients with AOⅢtype comminuted patellar fracture treated in Yunfu People's Hospital from May 2013 to May 2018 were randomly divided into open group and closed group,with 40 patients in each group.Patients in open group were treated by open reduction tension band internal fixation,while patients in closed group were underwent closed reduction tension band internal fixation.Differences of clinical effects between two groups were compared after 6 months'follow-up.Results Operation time,intraoperative estimate blood loss volume,incision length,hospital stay,fracture healing time and postoperative complications in closed group were significantly less than those in open group,and Hospital for Special Surgery(HSS)knee scores at 2 weeks,1,3,6 months postoperatively in closed group were higher than those in open group(P<0.05).Conclusion For patients with AOⅢtype comminuted patellar fracture,closed reduction tension band internal fixation has the advantages of less trauma,faster fracture healing and knee joint function recovery,lower incidence of postoperative complications and better short term effects when compared with open reduction tension band procedure.