髌骨针与克氏针张力带治疗老年髌骨粉碎性骨折的临床疗效对比

目的总结探讨使用髌骨针与克氏针张力带治疗老年髌骨粉碎性骨折的临床疗效。方法以我院2014年1月至2017年1月收治的62例老年髌骨粉碎性骨折患者作为研究对象,照随机数表法,随机分为观察组和对照组,每组31人。对照组采用张力带钢丝对患者进行治疗,观察组则采用髌骨针进行治疗。治疗后,分析比较2组患者的手术时间、骨折愈合时间及住院时间,并对患者的关节屈曲度、Bostman评分及术后并发症进行统计分析。结果骨折愈合时间及住院时间两组无明显差异(0.05)。手术时间观察组(35±3.33)min,对照组(55±5.41)min,观察组患者的手术时间明显少于对照组(0.05);患者膝关节屈曲度观察组(144.25±5.22)°,对照组(122.34±5.32)°,观察组患者膝关节屈曲度明显大于对照组(0.05);Bostman评分观察组(28.22±1.33)分,对照组(20.81±2.67)分,观察组Bostman评分明显高于对照组(0.05)。至末次随访时,观察组出现1例术后并发症,对照组有9例术后并发症,观察组术后并发症发生率明显低于对照组,两组比较有统计学差异(0.05)。结论对老年髌骨粉碎性骨折患者采用髌骨固定针治疗,效果显著,术后膝关节功能恢复良好,值得临床推广应用。

Clinical effect of patellar fixed needle tension and kirschner wires tension band for the treatment of senile patient patellar comminuted fracture

Objective To evaluate the clinical effects of the surgical treatment of senile patient patellar comminuted fractures with patellar fixed needle and kirschner wires tension band from January 2014 to January 2017. Methods 62 senile patient with patellar comminuted fracture in our hospital were selected as research object. 62 senile patient were randomly divided into control group and observation group, with 31 cases in each. The control group was treated with tension band steel wire, while the observation group was treated with patellar fixed needle tension. After treatment, the operation time, fracture healing time and hospitalization time were compared between the two groups, and the joint flexion degree, Bostman score and postoperative complications were analyzed. Results There was no significant difference in fracture healing time and hospitalization time between the two groups (P>0.05).The operation time was observed in the observation group (35±3.33) min, and the control group (55±5.41) min. The operation time of the observation group was significantly less than that of the control group (P<0.05).The knee flexion degree of observation group was (144.25±5.22)°, the control group was (122.34±5.32)°,the knee flexion of the observation group was significantly higher than that of the control group (P<0.05); the Bostman score of observation group was (28.22±1.33), the control group was (20.81±2.67), the Bostman score was significantly higher than the control group (P<0.05).At the last follow-up, there was 1 postoperative complication in the observation group and 9 postoperative complications in the control group. The postoperative complication rate in the observation group was significantly lower than that in the control group (P<0.05). There was a significant difference between the two groups. Conclusion It is effective and safe to treat the comminuted patellar fracture with patellar fixed needle tension. It is worthy of clinical application.