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带孔克氏针横向固定联合钛缆荷包缝合治疗髌骨粉碎性骨折难愈合的临床疗效

[Clinical effects of Kirschner wire with hole transverse fixation combined with titanium cable purse string suture for the treatment of refractory fracture of patellar comminuted fracture].

作者信息

Yang Rong, Yang Xiao-Dong, Shu Fan, Zhang Hao

机构信息

Department of Orthopaedics, Ningbo No.9 Hospital, Ningbo 315020, Zhejiang, China;

Department of Orthopaedics, Ningbo No.9 Hospital, Ningbo 315020, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2018 Oct 25;31(10):894-898. doi: 10.3969/j.issn.1003-0034.2018.10.003.

Abstract

OBJECTIVE

To explore clinical effects of Kirschner wire with hole transverse fixation combined with titanium cable purse string suture in treating refractory fracture of patellar comminuted fracture.

METHODS

From January 2014 to January 2016, 17 comminuted fracture treated by Kirschner wire with hole transverse fixation combined with titanium cable purse string suture were retrospectively analyzed, including 10 males and 7 females aged from 28 to 67 years old with an average of (48.7±3.2) years old. According to AO/OTA fracture classification, all fractures were type 34-C3.2. Operative time, blood loss, intervals of the first functional exercise postoperatively and complications were observed. Meanwhile, function recovery was evaluated by Böstman scoring at 10 months after operation.

RESULTS

All patients were followed up with an average of(14.6±2.1) months ranged from 10 to 24 months. All incisions healed at stage I. Clinical fracture healing time ranged from 11.7 to 16.5 weeks with an average of (12.7±1.7) weeks; operative time ranged from 67 to 95 min with an average of (71.4±11.5) min; blood loss ranged from 41 to 72 ml with an average of (57.0±7.5) ml; the first time of functional exercise ranged from 2 to 5 d with an average of (2.2±1.7) d. No complications including Kirschner pin stabbing the skin, loose or slippery of Kirschner pin, bursitis with pain brought by tip of Kirschner pin, wire escaped and broken occurred. Postoperative Böstman score at 10 months were 28.15±1.74, 12 patients got excellent results, 4 well and 1 lose.

CONCLUSIONS

Kirschner wire with hole transverse fixation combined with titanium cable purse string suture in treating refractory fracture of patellar comminuted fracture has advantages of simple operation, good anatomical reduction, stable fixation and less complications, which is worth popularizing.

摘要

目的

探讨带孔克氏针横向固定联合钛缆荷包缝合治疗髌骨粉碎性骨折的临床效果。

方法

回顾性分析2014年1月至2016年1月采用带孔克氏针横向固定联合钛缆荷包缝合治疗的17例髌骨粉碎性骨折患者,其中男10例,女7例,年龄28~67岁,平均(48.7±3.2)岁。根据AO/OTA骨折分类,均为34-C3.2型。观察手术时间、出血量、术后首次功能锻炼时间及并发症情况。同时,术后10个月采用Böstman评分评估功能恢复情况。

结果

所有患者均获随访,平均(14.6±2.1)个月,随访时间10~24个月。所有切口均Ⅰ期愈合。临床骨折愈合时间11.7~16.5周,平均(12.7±1.7)周;手术时间67~95分钟,平均(71.4±11.5)分钟;出血量41~72毫升,平均(57.0±7.5)毫升;首次功能锻炼时间2~5天,平均(2.2±1.7)天。未出现克氏针戳破皮肤、克氏针松动或滑脱、克氏针尖端疼痛性滑囊炎、钢丝脱出及断裂等并发症。术后10个月Böstman评分为28.15±1.74,优12例,良4例,差1例。

结论

带孔克氏针横向固定联合钛缆荷包缝合治疗髌骨粉碎性骨折具有操作简单、解剖复位良好、固定稳定、并发症少等优点,值得推广。

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