闭合复位克氏针张力带内固定治疗横形髌骨骨折的临床观察

doi:10.3969/j.issn.1005-6483.2021.07.019

摘要/Abstract

摘要： 目的观察闭合复位克氏针张力带内固定治疗横形髌骨骨折的临床疗效。
方法 2018年4月~2019年10月收治的横形髌骨骨折40例，采取前瞻随机对照方法分为两组，观察组20例，采取闭合复位克氏针张力带内固定治疗；对照组20例，采取切开复位克氏针张力带内固定治疗。比较两组病人手术切口长度，手术时间，术后3天、2周、1.5个月、6个月的膝关节视觉模拟评分(visual analogue scale,VAS)及膝关节Lysholm评分。
结果对照组和观察组手术时间分别为(64.46±7.46)分钟和(79.24±9.23)分钟，两组比较差异有统计学意义(P＜0.05)；对照组术中无透视，观察组透视时间(15.36±2.51)分钟。对照组和观察组术后3天、2周膝关节VAS评分分别为(4.86±0.74)分和(3.54±0.86)分，(3.12±0.54)分和(1.65±0.62)分，两组比较差异有统计学意义（P＜0.05)，Lysholm评分分别为(19.31±3.25)分和(25.41±4.23)分、(34.56±3.10)分和(40.25±4.56)分，两组比较差异有统计学意义(P＜0.05)，术后1.5个月、6个月膝关节VAS分别为(1.14±0.31)分和(1.08±0.26)分、(0.63±0.19)分和(0.61±0.18)分，Lysholm评分分别为(56.23±3.12)分和(59.21±2.14)分、(85.35±1.54)分和(84.58±1.96)分，两组比较差异无统计学意义(P>0.05)。所有病人均接受至少6个月的随访，40例病人术后均未发生关节感染、内固定松动、神经血管损伤等术后并发症。
结论闭合复位克氏针张力带内固定治疗横形髌骨骨折临床疗效满意，不切开，创伤小，能够早期恢复，术后早期疼痛较轻的优势。

关键词: 闭合复位, 切开复位, 克氏针张力带, 髌骨骨折

Abstract: Objective To evaluate the clinical effects of patella fracture treated by closed reduction and kirschner wire tension band internal fixation.
Methods From April 2018 to October 2019,40 patients with transverse patella fracture were studied.20 cases in the observation group was treated by closed reduction and kirschner wire tension band internal fixation,20 cases in the control group treated by open reduction kirschner tension band.The surgical incision length,operation time,knee visual analogue scale(VAS) and knee Lysholm score at 3 days,2 weeks,1.5 months and 6 months after surgery of 2 groups were recorded and compared.
Results Compared with the control group,the observation group had longer operation time [(64.46±7.46) min vs.(79.24±9.23) min,P＜0.05].There was no fluoroscopy in the control group,and the observation group fluoroscopy time was(15.36±2.51) min.Compared with the control group,the knee joint VAS of the observation group [(4.86±0.74) points vs.(3.54±0.86) points,(3.12±0.54) points vs.(1.65±0.62) points] at 3 days and 2 weeks after surgery had decreased(all P＜0.05),Lysholm score [(19.31±3.25) points vs.(25.41±4.23) points,(34.56±3.10) points vs.(40.25±4.56 points] had increased(all P＜0.05).The knee joint VAS [(1.14±0.31) points vs.(1.08±0.26) points,(0.63±0.19) points vs.(0.61±0.18) points] and Lysholm scores [(56.23±3.12) points vs.(59.21±2.14) points,(85.35±1.54) points vs.(84.58±1.96) points] at 1.5 months and 6 months after surgery in 2 groups had no significant differences(all P>0.05).All patients received at least 6 months of follow-up,none of 40 patients had postoperative complications such as joint infection,loosening of internal fixation,neurovascular injury and other postoperative complications.
Conclusion The closed reduction and kirschner wire tension band internal fixation can be used to treat patella fracture,which has a satisfactory clinical effect,with no incision,less trauma,early recovery and less pain.

Key words: closed reduction, open reduction, kirschner wire tension band, patella fracture

陈多军朱晓龙. 闭合复位克氏针张力带内固定治疗横形髌骨骨折的临床观察[J]. 临床外科杂志, 2021, 29(7): 659-662.

CHEN Duojun, ZHu Xiaolong.. Clinical observation of patella fracture treated by closed reduction and kirschner wire tension band internal fixation[J]. JOURNAL OF CLINICAL SURGERY, 2021, 29(7): 659-662.

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