两种方法治疗髌骨下极骨折的疗效比较

Efficacy comparison of two kinds of methods for treatment of the patellar inferior pole fracture

目的比较不锈钢缝线三维立体缝合逐级复位固定与克氏针钢丝捆扎“8”字张力带治疗髌骨下极骨折的疗效。方法将40例髌骨下极骨折患者按照固定方法不同分为观察组(采用不锈钢缝线三维立体缝合逐级复位固定治疗,20例)和对照组(采用克氏针钢丝捆扎“8”字张力带治疗,20例)。比较两组手术情况,采用Lysholm评分评定膝关节功能。结果患者均获得随访,时间8~15个月。手术时间观察组明显短于对照组(P<0.05)。两组骨折对位对线良好,关节面平整,均达解剖复位,切口均一期愈合。并发症发生率观察组明显低于对照组(P<0.05)。末次随访时,膝关节屈曲活动度观察组明显大于对照组(P<0.05),两组患者步态均无明显异常;采用Lysholm评分评定膝关节功能的优良率,观察组明显高于对照组(P<0.05)。结论与克氏针钢丝捆扎“8”字张力带相比,不锈钢缝线三维立体缝合逐级复位固定治疗髌骨下极骨折手术时间短、并发症发生率低,更利于患者膝关节功能的恢复。

Objective To compare the effect of three-dimensional stainless steel suture step-by-step reduction and fixation and Kirschner wire tension band with 8-shaped steel wire binding in treatment of patellar inferior pole fracture.Methods According to the different fixation methods,40 patients with patellar inferior pole fractures were divided into observation group(using stainless steel three-dimensional suture method step-by-step reduction and fixation treatment,20 cases)and control group(using Kirschner wire tension band with 8-shaped steel wire binding treatment,20 cases).The operation situation was compared between two groups,Lysholm score was used to evaluate knee function.Results All patients were followed up for 8~15 months.The operation time of observation group was significantly shorter than that of control group(P<0.05).The two groups had good alignment,smooth articular surface,anatomic reduction and primary healing.The incidence rate of complications in the observation group was significantly lower than that in the control group(P<0.05).At the last follow-up,the knee flexion activity in the observation group was significantly larger than that in the control group(P<0.05),but there was no obvious abnormal gait in both groups;the excellent and good rate of knee joint function assessed by Lysholm score in the observation group was significantly higher than that in the control group(P<0.05).Conclusions In the treatment of patellar inferior pole fracture,the three-dimensional stainless steel suture and progressive reduction and fixation can shorten the operation time and reduce the incidence of complications,compared with Kirschner wire tension band with 8-shaped steel wire binding,and which is beneficial to the recovery of knee joint function.