Shi Lin-Jun, Wu Cong-Cong
Department of Orthopaedics, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang, China.
Zhongguo Gu Shang. 2023 Mar 25;36(3):247-50. doi: 10.12200/j.issn.1003-0034.2023.03.010.
To investigate the clinical effect of double pulley combined with suture bridge in the treatment of comminuted fracture of the lower pole of the patella.
From January 2018 to June 2020, 15 patients with comminuted fracture of the lower pole of the patella were treated with double pulley and suture bridge technology, including 9 males and 6 females, aged 28 to 68 years old with an average of (42.4±9.6) years old. All patients had obvious knee joint pain and limited movement after injury. All knee joints were examined by X-ray and CT, which confirmed that they were all comminuted fractures at the lower level of the patella. After operation, X-ray films of the knee joint were taken regularly to understand the fracture healing, the Insall Salvati index was measure, the range of motion of the joint was recorded, and the function of the knee joint was evaluateed by the Bostman scoring system.
All the 15 patients were followed up for 7 to 24 months with an average of (11.4±4.2) months, and there was no obvious anterior knee pain. At the last follow-up, the knee joint range of motion of the affected limb was 105° to 140° with an average of (128.5±12.8) °, and the Insall Salvati index was 0.79 to 1.12 with an average of (0.92±0.18). The X-ray film showed that the patella was bone healing, and no anchor fell off, broken, or displaced fracture block was found. Bostman patellar fracture function score was 27.85±2.06, 13 cases were excellent, 2 cases were good.
Double pulley technique combined with suture bridge technique is reliable for reduction and fixation of comminuted fracture of the lower pole of patella, and patients can start functional exercise early after operation.
探讨双滑轮联合缝线桥技术治疗髌骨下极粉碎性骨折的临床效果。
选取2018年1月至2020年6月采用双滑轮联合缝线桥技术治疗的15例髌骨下极粉碎性骨折患者，其中男性9例，女性6例，年龄28～68岁，平均（42.4±9.6）岁。所有患者伤后均有明显膝关节疼痛及活动受限。所有膝关节均行X线及CT检查，证实均为髌骨下极粉碎性骨折。术后定期拍摄膝关节X线片了解骨折愈合情况，测量Insall Salvati指数，记录关节活动度，并采用Bostman评分系统评价膝关节功能。
15例患者均获随访，随访时间7～24个月，平均（11.4±4.2）个月，膝关节前方无明显疼痛。末次随访时，患侧膝关节活动度为105°～140°，平均（128.5±12.8）°，Insall Salvati指数为0.79～1.12，平均（0.92±0.18）。X线片显示髌骨骨折愈合，未发现锚钉脱落、断裂或骨折块移位。Bostman髌骨骨折功能评分为27.85±2.06，优13例，良2例。
双滑轮技术联合缝线桥技术治疗髌骨下极粉碎性骨折复位固定可靠，患者术后可早期进行功能锻炼。
