髌骨固定针与克氏针结合钢丝张力带治疗髌骨骨折疗效比较

Comparison of patella fixed needle and kirschner wires combined with steel with tension band in treatment of patella fracture

目的:比较髌骨固定针与克氏针结合钢丝张力带治疗髌骨骨折的疗效.方法:回顾分析我科自2016年3月-2018年6月采用髌骨固定针结合钢丝张力带治疗髌骨骨折42例(髌骨针组),克氏针44例(克氏针组).髌骨针组男性15例,女性27例;年龄26-69(50.1±14.2)岁.克氏针组:男性18例,女性26例;年龄32-72(57.2±13.3)岁.观察2组骨折分型,手术时间,术中失血量,骨折愈合时间,术后并发症,Bostman标准评价术后疗效.结果:86例患者均获得随访,随访时间13-24个月,平均15.4个月,手术时间2组无统计学差异(47.9±9.3,53.6±8.6,t=1.891,p=0.067),但髌骨针组所用平均手术时间较克氏针组少.依据Bostman标准,髌骨针组优良率100%,克氏针组90%,2组无统计学差异,克氏针组有14例术后不同程度克氏针松动拔出.结论:与克氏针相比,髌骨固定针结合钢丝张力带治疗髌骨骨折操作更简单,固定牢靠,并发症少,膝关节功能恢复好,是治疗髌骨骨折的良好选择.

Objective:To compare the efficacy of patella fixed needle and kirschner wires combined with steel wire tension band in the treatment of patella of patella fracture.Methods:From March 2016 to June 2018,42 cases of patella fracture were treated with patella fixed needle combined with steel wire tension band in our department(15 males and 27 females,aged 26 to 69 with an average of 50.1 years old);44 cases were treated with kirschner wires tension band(18 males and 26 cases females,aged 32 to 72 with an average of 57.2 years old).Fracture classification,operation time,intra-operative blood loss,fracture healing time,postoperative complications and Bostman criteria were observed in the two groups to evaluate the postoperative efficacy.Results:All the 86 patients were followed up for 13 to 24 months,with an average of 15.4 months.There was no statistical difference in the operation time between the two groups(47.99.3,53.68.6,t=1.891,p=0.067),but the average operation time of the patella needle group was less than that of the kirschner group.According to the Bostman standard,the excellent and good rate of patella needle group was 100%,and that of the kirschner wire group was 90.9%•There was no statistical difference between the two groups.But there were 14 cases of kirschner wires loose and pulled out in different degrees after surgery in the kirschner wire group.Conclusion:Compared with kirschner wires patella fixed needle combined with steel wire tension band might be a better method to treat patella fracture.