髌骨爪联合可调外固定膝关节支具治疗髌骨粉碎性骨折

Treatment of patellar comminuted fracture with patellar claw combined with adjustable external fixation knee brace

目的观察髌骨爪联合可调外固定膝关节支具治疗髌骨粉碎性骨折的临床疗效。方法采用髌骨爪联合可调外固定膝关节支具治疗25例髌骨粉碎性骨折患者。记录手术时间、骨折愈合时间、膝关节活动度、术后并发症发生情况。采用Bostman膝关节评分评价疗效。结果患者均获得随访,时间12~20个月。手术时间40~90 min,骨折愈合时间6~10周。末次随访时,无骨折再移位、不愈合或畸形愈合及内固定松动、断裂、脱落等并发症发生。术后10个月,膝关节活动度:伸直0°,屈曲110°~135°,均未出现膝关节僵直及活动障碍等问题;按照Bostman膝关节评分评价疗效:优18例,良6例,差1例,优良率24/25。结论采用髌骨爪联合可调外固定膝关节支具治疗髌骨粉碎性骨折,具有固定牢靠、患者恢复快的优势,在可调外固定膝关节支具的保护下,患者可张弛有度的进行膝关节功能锻炼,减少甚至避免了术后并发症的发生,临床效果满意。

Objective To observe the clinical effect of patellar claw combined with adjustable external fixation knee brace in the treatment of patellar comminuted fracture.Methods The 25 cases of patellar comminuted fractures were performed with patellar claw combined with adjustable external fixation knee brace.The surgery duration,fracture healing time,knee range of motion(ROM),postoperative complications were recorded,the effect was assessed with Bostman knee joint score.Results All patients were followed up for 12~20 months,the operation time was 40~90min,fracture healing time was 6~10 weeks.At the last follow-up,no complications such as re-displacment of fracture,nonunion,deformity healing,and loosening,fracute and dislocation of the internal fixation occurred.At 10 months postoperation,the knee ROM was extension with 0°,and flexion with 110°~135°,and there was no stiff knee joint and activities obstacles.According to Bostman knee score to evaluate the therapeutic effect,18 cases were excellent,6cases were good,and poor 1 case,with the excellent-good rate of 93.1%.Conclusions The patellar claw combined with adjustable external fixation knee brace in the treatment of patellar comminuted fracture have the advantages of firm fixation,fast recovery,early functional exercise of knee joint,which can reduce the incidence of complications,and obtaine satisfactory clinical effect.