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不可吸收缝线环扎联合髌骨爪固定治疗髌骨下极骨折的临床观察

[Clincal observation of non-absorbable suture cerclage combined with patella claw fixation for treatment of inferior patella fractures].

作者信息

Wang Peizhao, Han Xu, Wang Xiao, Yu Jinyang, Yuan Yanhao, Tan Honglue

机构信息

Henan University of Chinese Traditional Medicine, Zhengzhou Henan, 450046, P.R.China;The 3rd Department of Knee Injury, Henan Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang Henan, 471002, P.R.China.

The 3rd Department of Knee Injury, Henan Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang Henan, 471002, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Oct 15;34(10):1243-1247. doi: 10.7507/1002-1892.202003178.

Abstract

OBJECTIVE

To investigate the effectiveness of non-absorbable suture cerclage combined with patella claw fixation for the treatment of inferior patella fractures.

METHODS

Between September 2016 and January 2019, 22 patients with inferior patella fractures were treated. There were 12 males and 10 females, with a mean age of 49.1 years (range, 32-67 years). The causes of injury were traffic accident in 8 cases, falling in 12 cases, and other causes in 2 cases. The interval from injury to operation was 3-7 days (mean, 4.4 days). For the operation, 3 or 4 longitudinal tunnels were drilled backward from the surface of the proximal fracture fragment with Kirschner wires; under the guidance of lumbar puncture needles and steel wires, non-absorbable suture passed through the tunnels and encircled the inferior fracture fragment, then tighten to achieve a satisfactory reduction of the fracture; finally, the patella claw was used to strengthen the fixation. During the follow-up, complications were observed, maximum motion range of the knee joint was measured, X-ray examination was performed and fracture healing time was recorded. The knee function was evaluated according to Böstman scores.

RESULTS

All the 22 patients were followed up 12-36 months (mean, 19.4 months). No infection, joint stiffness, bone nonunion, loss of reduction, or displacement of internal fixation occurred. All fractures were clinically healed, and the bone healing time was 2-3 months (mean, 2.6 months). At last follow-up, the maxium motion range of knee joint was 130°-135°, with an average of 132.6°. The Böstman score of the affected knee was 28-30 (mean, 29.2). All cases were graded as excellent results.

CONCLUSION

Non-absorbable suture cerclage combined with patella claw fixation for inferior patella fractures has the advantages of simple operation, reliable fixation, and few complications, and the clinical results are satisfactory.

摘要

目的

探讨不可吸收缝线环扎联合髌骨爪固定治疗髌骨下极骨折的疗效。

方法

2016年9月至2019年1月,收治22例髌骨下极骨折患者。其中男12例,女10例,平均年龄49.1岁(范围32 - 67岁)。受伤原因:交通事故8例,跌倒12例,其他原因2例。受伤至手术间隔时间为3 - 7天(平均4.4天)。手术时,用克氏针从近端骨折块表面向后钻3或4条纵向隧道;在腰穿针和钢丝引导下,不可吸收缝线穿过隧道并环绕下极骨折块,然后收紧以实现骨折满意复位;最后,用髌骨爪加强固定。随访期间,观察并发症,测量膝关节最大活动范围,进行X线检查并记录骨折愈合时间。根据Böstman评分评估膝关节功能。

结果

22例患者均获随访,随访时间12 - 36个月(平均19.4个月)。未发生感染、关节僵硬、骨不连、复位丢失或内固定移位。所有骨折均临床愈合,骨愈合时间为2 - 3个月(平均2.6个月)。末次随访时,膝关节最大活动范围为130° - 135°,平均132.6°。患膝Böstman评分为28 - 30分(平均29.2分)。所有病例均评定为优良结果。

结论

不可吸收缝线环扎联合髌骨爪固定治疗髌骨下极骨折具有手术操作简单、固定可靠、并发症少的优点,临床效果满意。

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[Effectiveness of high strength suture fixation in treatment of patellar transverse fracture].高强度缝线固定治疗髌骨横行骨折的疗效
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Jun 15;32(6):694-697. doi: 10.7507/1002-1892.201712082.
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Comminuted displaced fractures of the patella.髌骨粉碎性移位骨折。
Injury. 1981 Nov;13(3):196-202. doi: 10.1016/0020-1383(81)90238-2.

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