空心无头加压螺钉钛缆张力带内固定术对髌骨骨折患者并发症及膝关节功能的影响

The effect of hollow headless compression screw titanium cable tension band internal fixation on complications and knee joint function in patients with patellar fractures

目的探讨空心无头加压螺钉钛缆张力带内固定术对髌骨骨折(patellar fracture,PF)患者并发症及膝关节功能的影响。方法选取2020年6月至2022年2月平度市第三人民医院收治的92例PF患者作为研究对象,按照随机数字表法分为对照组与观察组,每组46例。对照组予以克氏针钢丝张力带内固定术治疗,观察组予以空心无头加压螺钉钛缆张力带固定术治疗。比较两组围手术期指标、临床疗效、并发症发生情况、疼痛情况[视觉模拟评分法(visual analogue scale,VAS)评分]、膝关节功能及生命质量[生命质量综合评定问卷(generic quality of life inventory-74,GQOLI-74)评分]。结果两组术中失血量、手术时间及住院时间比较差异无统计学意义;观察组下床活动时间短于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为95.65%,高于对照组的82.61%,差异有统计学意义(P<0.05)。观察组并发症发生率为4.35%,低于对照组的19.57%,差异有统计学意义(P<0.05)。治疗后,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组疼痛程度、工作能力、肌萎缩程度、关节活动范围、辅助物使用及积液情况评分均高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组物质生活、社会功能、生理及心理功能评分均高于对照组,差异有统计学意义(P<0.05)。结论空心无头加压螺钉钛缆张力带内固定术治疗PF疗效显著,可缩短患者术后恢复时间,减少并发症发生,减轻术后疼痛,促进膝关节功能恢复,提高患者生命质量,值得临床推广应用。

Objective To explore the effect of hollow headless compression screw titanium cable tension band internal fixation on complications and knee joint function in patients with patellar fractures(PF).Methods 92 patients with PF admitted to Pingdu Third People's Hospital from June 2020 to February 2022 were selected as the research subjects,and they were divided into the control group and the observation group according to the random number table method,with 46 cases in each group.The control group was treated with Kirschner wire tension band internal fixation,while the observation group was treated with hollow headless compression screw titanium cable tension band fixation.The perioperative indicators,clinical efficacy,complications,pain situation(visual analogue scale[VAS]score),knee joint function and quality of life(generic quality of life inventory-74[GQOLI-74]score)were compared between the two groups.Results There were no significant differences in intraoperative blood loss,surgical time and hospital stay between the two groups;time out of bed in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The total clinical effective rate in the observation group was 95.65%,which was higher than 82.61%in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 4.35%,which was lower than 19.57%in the control group,and the difference was statistically significant(P<0.05).After treatment,the VAS score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the degree of pain,work ability,muscle atrophy,joint range of motion,use of assistive devices and fluid accumulation in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the material life,social function,physiological and psychological scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The implementation of hollow headless compression screw titanium cable tension band internal fixation for PF patients has significant the rapeutic effect,can shorten postoperative recovery time,reduce complications,alleviate postoperative pain,promote knee joint function recovery,and improve quality of life of patients,which is worthy of clinical promotion and application.