克氏针8字张力带钢丝治疗髌骨骨折

Kirschner wire and 8-shaped tension band wire for treatment of patellar fracture

目的 探讨克氏针8字张力带钢丝治疗髌骨骨折的临床疗效。方法 采用克氏针8字张力带钢丝治疗18例髌骨骨折。记录手术情况,比较手术前后疼痛VAS评分、Lysholm评分。结果 手术时间30~55(43.0±8.1)min,术中出血量5~20(10.6±2.3)ml,住院时间5~12(7.8±1.6)个月。切口均一期愈合。术后1例滑膜炎,使用消炎镇痛药、热敷等对症治疗后症状改善。患者均获得随访,时间12~16(13.5±2.1)个月。骨折愈合时间4~6个月。患者均在术后1个月拄拐下地锻炼,术后4个月负重行走。疼痛VAS评分、Lysholm评分术后6个月均较术前显著改善(P<0.01)。术后6个月,采用Lysholm评分评定疗效:优12例,良4例,可1例,差1例,优良率16/18。结论 克氏针8字张力带钢丝治疗髌骨骨折操作简单、创伤小,患者可早期功能锻炼,临床疗效确切。

Objective To investigate the clinical effect of Kirschner wire and 8-shaped tension band wire on patellar fracture.Methods The 18 cases of patellar fractures were treated by Kirschner wire and 8-shaped tension band wire.The surgical situation was recorded,the pain VAS and Lysholm score were compared before and after the operation.Results The operative time was 30 ~ 55(43. 0 ± 8. 1) min,the intraoperative blood loss was 5 ~ 20(10. 6 ± 2. 3)ml,the hospital stay was 5 ~ 12(7. 8 ± 1. 6) months. All the incisions healed in one-stage. Postoperative synovitis occurred in 1 case,which was improved after symptomatic treatment with anti-inflammatory and analgesic drugs and hot compress. All patients were followed up for 12 ~ 16(13. 5 ± 2. 1) months. Fracture healing time was 4 ~ 6 months. All patients exercised on crutches at 1 month after surgery,and walked with weight-bearing at 4 months after surgery. The pain VAS and Lysholm score were significantly improved at 6 months after surgery,compared with those before surgery(P< 0. 05). At 6 months after the operation,the assessment result with Lysholm score criterion:excellent in 12 cases,good in 4 cases, fair 1 case and poor 1 case, with an excellent-good rate of 16/18.Conclusions The treatment of patellar fracture with Kirschner wire and 8-shaped tension band wire is simple,less trauma,early functional exercise,and clinical effect is definite.