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单根钛丝环扎及“8”字张力带治疗髌骨骨折的疗效观察

[Effectiveness of cerclage and a figure-of-eight tension band by a single titanium wire in treatment of patellar fracture].

作者信息

Chen Chunyong, Ye Junjian, Xie Yun, Lin Zhangxiong, Xie Qiyang, Qiu Yaoyu, Wu Gui, Wang Fasheng

机构信息

Department of Orthopaedic Trauma, the First Affiliated Hospital of Fujian Medical University, Trauma Center of Fujian, Fuzhou Fujian, 350004, P.R.China.

Department of Orthopaedic Trauma, the First Affiliated Hospital of Fujian Medical University, Trauma Center of Fujian, Fuzhou Fujian, 350004,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Jul 15;31(7):805-809. doi: 10.7507/1002-1892.201702021.

Abstract

OBJECTIVE

To estimate the outcome of cerclage followed by a figure-of-eight tension band with a single titanium wire for the treatment of patellar fracture.

METHODS

A retrospective analysis was made on the clinical data of 46 patients with patellar fractures treated between June 2012 and November 2014. There were 30 males and 16 females, aged 20-86 years (mean, 54 years). The fracture causes included falling in 27 cases, traffic accident in 16 cases, and knock in 3 cases. There were 41 cases of closed fractures and 5 cases of open fracture. The injury located at the left side in 24 cases and the right side in 22 cases. According to AO classification, fracture was rated as type 34-A in 3 cases, as type 34-B in 1 case, as type 34-C1 in 7 cases, as type 34-C2 in 13 cases, and as type 34-C3 in 22 cases. The time between injury and operation ranged 1-12 days (mean, 3.7 days). During operations, a single titanium wire was used to pass around the patellar, followed a figure-of-eight wrapping, to tight and fix at the tension of 35 kg.

RESULTS

All incisions healed primarily. The patients were followed up 20.6 months on average (range, 6-24 months). Partial wire loosening was found in 2 cases, irritation of skin or soft tissue in 1 case. The X-ray examination showed bony healing at 3 months after operation, without breakage of titanium wire. The internal fixation was removed in 38 cases at 12 months after operation. According to the Böstman rating score, the mean score was 28.34 (range, 24-30) at 12 months after ope-ration; the results were excellent in 42 cases and good in 4 cases, with an excellent and good rate of 100%.

CONCLUSION

For patellar fracture, cerclage followed by a figure-of-eight tension band with a single titanium wire is able to achieve an effective stability and to allow early motion for patient with less complication.

摘要

目的

评估采用单根钛丝“8”字张力带环扎治疗髌骨骨折的疗效。

方法

回顾性分析2012年6月至2014年11月期间收治的46例髌骨骨折患者的临床资料。其中男性30例,女性16例,年龄20 - 86岁(平均54岁)。骨折原因包括跌倒27例、交通事故16例、撞击3例。闭合性骨折41例,开放性骨折5例。损伤位于左侧24例,右侧22例。根据AO分类,3例为34 - A型骨折,1例为34 - B型骨折,7例为34 - C1型骨折,13例为34 - C2型骨折,22例为34 - C3型骨折。受伤至手术时间为1 - 12天(平均3.7天)。手术中使用单根钛丝环绕髌骨,呈“8 ”字缠绕,以35 kg的张力收紧固定。

结果

所有切口均一期愈合。患者平均随访20.6个月(6 - 24个月)。2例出现部分钢丝松动,1例出现皮肤或软组织刺激。术后3个月X线检查显示骨折愈合,钛丝无断裂。38例患者术后12个月取出内固定。根据Böstman评分,术后12个月平均评分为28.34分(24 - 30分);优42例,良4例,优良率为100%。

结论

对于髌骨骨折,采用单根钛丝“8”字张力带环扎能够获得有效的稳定性,使患者早期活动,并发症较少。

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1
Incidence and Epidemiology of Patellar Fractures.髌骨骨折的发病率及流行病学
Orthopedics. 2016 Nov 1;39(6):e1154-e1158. doi: 10.3928/01477447-20160811-01. Epub 2016 Aug 18.
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Current Treatment Strategies for Patella Fractures.髌骨骨折的当前治疗策略
Orthopedics. 2015 Jun;38(6):377-84. doi: 10.3928/01477447-20150603-05.
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Percutaneous cerclage wiring for the surgical treatment of displaced patella fractures.经皮环扎钢丝术治疗移位髌骨骨折
Strategies Trauma Limb Reconstr. 2014 Apr;9(1):19-23. doi: 10.1007/s11751-014-0184-0. Epub 2014 Feb 5.
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J Am Acad Orthop Surg. 2011 Apr;19(4):198-207. doi: 10.5435/00124635-201104000-00004.
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Fractures of the patella.髌骨骨折
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