微型钢板联合改良张力带钢丝治疗髌骨下极撕脱性骨折的疗效评价

目的探讨微型钢板联合改良张力带钢丝治疗髌骨下极撕脱性骨折的临床疗效.方法回顾性分析2015年3月至2019年4月采用微型钢板联合改良张力带钢丝治疗23例髌骨下极撕脱性骨折的患者,记录骨折愈合的时间,末次随访采用膝关节活动度、Bostman评分评定膝关节的功能.结果23例患者均获得随访,随访12~18个月,平均14月.骨折愈合时间8~12周,平均9.6周.末次随访时膝关节活动度105°~140°,平均127.5°,Bostman评分20~30分,平均26.1分.随访过程中未出现因植入物引起刺激症状,未发现内固定失败及骨折再移位等情况.结论微型钢板联合改良张力带钢丝治疗髌骨下极撕脱性骨折可获得牢靠的固定,允许膝关节早期活动,在改善膝关节功能方面疗效显著.

Objective To evaluate the clinical effect of a miniature plate in combination with the modified tension band wiring to treat patellar pole avulsion fractures.Methods From March 2015 to April 2019,twenty three patients with patellar pole avulsion fractures were treated by a miniature plate in combination with the modified tension band wiring,including 10 males and 13 females with an average of 56.3 years(range,28~85).The final range of the motion,the bone union time,and the Bostman score were recorded.Results All patients were followed up,the mean follow-up was 14 months,with a range of 12 to 18 months.The bone union time was 9.6weeks on average after the surgery(range was 8~12 weeks).At the final follow-up,the average range of motion arc was 127.50(range was 105~140°).The mean Bostman score at the last follow-up was 26.1 points(range was 20~30 points).There were no cases of irritation from the implant.No patient had loss of reduction or implant failure.Conclusion The treatment of patellar pole avulsion fractures with a miniature plate in combination with the modified tension band wiring provides sufficient stability,and allows for early range of motion,and provides excellent results interms ofkneefunction.