3种手术切口入路在髌骨骨折治疗中的应用效果

Application of three surgical incisions approaches in the treatment of patella fracture

目的比较3种手术切口入路在髌骨骨折治疗中的临床疗效。方法回顾性分析2018年3月至2020年3月大连大学附属中山医院收治的60例髌骨骨折患者的临床资料,根据不同手术切口入路分为膝前正中横形切口组、膝前正中纵形切口组及膝关节内侧纵弧形切口组,每组20例。比较3组围手术期指标、术后膝关节功能恢复情况及并发症发生情况。结果膝前正中纵形切口组、膝关节内侧纵弧形切口组手术时间、肿胀消退时间、住院时间、骨折愈合时间均短于膝前正中横形切口组,术中出血量少于膝前正中横形切口组,差异有统计学意义(P<0.05);膝前正中纵形切口组与膝关节内侧纵弧形切口组手术时间、肿胀消退时间、住院时间、骨折愈合时间、术中出血量比较差异无统计学意义。膝前正中纵形切口组及膝关节内侧纵弧形切口组术后膝关节功能恢复优良率均高于膝前正中横形切口组,差异有统计学意义(P<0.05),膝前正中纵形切口组与膝关节内侧纵弧形切口组比较差异无统计学意义。3组并发症发生率比较差异无统计学意义。结论膝关节前正中纵形切口及膝关节内侧纵弧形切口应用于髌骨骨折效果显著,损伤较小,坚强固定,可促进术后膝关节功能恢复,术后并发症较少,值得临床推广应用。

Objective To compare the clinical efficacy of three surgical incisions approaches in the treatment of patellar fracture.Methods The clinical data of 60 patients with patellar fracture admitted to Affiliated Zhongshan Hospital of Dalian University from March 2018 to March 2020 were retrospectively analyzed,they were divided into the transverse anterior knee median incision group,the longitudinal anterior knee median incision group and the medial longitudinal arc knee incision group according to different incision approaches,with 20 cases in each group.The perioperative indexes,postoperative knee function recovery and complications were compared among the three groups.Results The operation time,swelling reduction time,hospital stay time and fracture healing time in the longitudinal anterior knee median incision group and the medial longitudinal arc knee incision group were shorter than those in the transverse anterior knee median incision group,and the intraoperative blood loss was lower than that in the transverse anterior knee median incision group,the difference was statistically significant(P<0.05).There was no significant difference in operation time,swelling reduction time,hospital stay,fracture healing time and intraoperative blood loss between the longitudinal anterior knee median incision group and medial longitudinal arc knee incision group.The excellent and good rate of knee function recovery in the medial longitudinal arc knee incision group and the longitudinal anterior knee median incision group were higher than those in the transverse anterior knee median incision group,and the difference was statistically significant(P<0.05).There was no significant difference among the longitudinal anterior knee median incision group and the medial longitudinal arc knee incision group.There was no significant difference in the incidence of complications among the three groups.Conclusion The longitudinal incision in the median front of the knee joint and the longitudinal arc incision in the medial side of the knee joint have significant effects on patellar fracture,with less damage and strong fixation,which can promote the functional recovery of the knee joint after surgery and fewer postoperative complications,and are worthy of clinical promotion and application.