摘要
目的:探讨钢丝环扎结合空心螺钉张力带治疗髌骨骨折的临床效果。方法:2014年1月至2015年8月采用钢丝环扎结合空心螺钉钢丝张力带内固定治疗的髌骨骨折62例,左侧28例,右侧34例;男性33例,女性29例,年龄28-73岁,平均55.3岁;受伤原因:摔伤42例,车祸伤15例,高处坠落伤5例;AO/OTA分型A型5例,B型9例,C型48例;Rockwood分型Ⅱ型37例,Ⅲ型10例,V型15洲;闭合性骨折57洲,开放性骨折5例,受伤到手术时间8h-4天,平均1.8天,取髌前纵切口,复位骨折确认关节面平整,用0.8mm钢丝环扎固定,再用2枚1.2mm克氏针平行关节面打入,从骨折块小的一侧顺导针拧入2枚直径4.0mm空心螺钉,再用钢丝穿螺钉呈"8"字收紧。结果:62例患者随访3-25月,平均随访11月,无内固定失效,无骨折不愈合,骨折愈合时间6-11周,平均8.2周,1例患者术后感染,5例出现软组织激惹,Bostman疗效评分,优49例,良13例,优良率100%。结论:钢丝环扎结合空心螺钉张力带治疗髌骨可早期行关节功能锻炼,是髌骨骨折非常有效的治疗方法。
Objective:To investigate the clinical effects of patella fractures treated with circumferential wiring plus eannulated lag Screws tension band.Methods:From January 2014 to August 2015,62 cases were followed up.28 left and 34 right,33 males and 29 females,ages ranged from 28 to 73 years old(average55.3).AO/OTA classification,5 type A,9 type B,and 48 type C,Roockwood classification 37 type Ⅱ,10 type IB,15 type Ⅳ fractures.Injury to operating time 8h-4 days,an average 1.8 days,After openreduction,fractures were first fixed with circumferential wires(diameter 0.8 mm),and then two parallel K · wires were inserted from proximal bottom or distal pole across the fracture line,followed by two 4.0 mm eannulated lag screws respectively.Then 0.8 mm wire was passed through two screwscanal to create a figure-eight pattern tension band on the anterior surface of patellae,Results:62 patients were followed up 3 to 25 months,average 11 months,no internal fixation failure,no fracture nonunion,fracture healing time 6-11 weeks,average 8.2 weeks,1 case infection,5 cases with soft tissue irritability,Bostman efficacy score,49 cases,13 cases of benign,was 100%.Conclusion:circumferential wiring plus eannulated lag SCrews tension band can be early joint function exercise,is a very effective treatment of patella fracture
引文
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