可吸收双股线荷包缝合法结合聚髌器固定治疗髌骨粉碎性骨折的疗效

目的 探讨可吸收双股线荷包缝合法结合聚髌器固定治疗髌骨粉碎性骨折的临床疗效。方法 回顾性分析2019年1月至2022年12月入住中国人民解放军联勤保障部队第九〇一医院骨二科的髌骨粉碎性骨折患者86例，固定方式均为聚髌器固定。根据术中骨折复位方式不同，分为试验组（采用可吸收双股线荷包缝合法）和对照组（采用钳夹、克氏针维持复位）各43例。比较两组手术时间、骨折愈合时间、末次随访时膝关节功能及术后并发症发生情况。结果 所有患者均顺利完成手术，并随访4~18个月，平均（12.23±4.50）个月。两组骨折愈合时间比较，差异无统计学意义（P=0.290）。试验组手术时间短于对照组，末次随访时膝关节Bostman功能评价优良率高于对照组，差异均具有统计学意义（P均< 0.05）。两组患者切口均一期愈合，无皮缘坏死、骨折再移位、聚髌器松动、骨折不愈合等并发症发生。结论 可吸收双股线荷包缝合法结合聚髌器固定治疗髌骨粉碎性骨折更利于术中复位骨折，减少手术时间，利于膝关节功能恢复。

Efficacy of treatment ofabsorbable double strand suture through purse-string combined with patellar concentrator fixation in patellar fractures

Objective Toinvestigate the efficacy of the treatment ofabsorbable double strand suture through purse-string combined with patellar concentrator fixation in patients with patellar fractures. Methods A retrospective analysis was conducted on 86 patients with patellar comminuted fractures admitted to the Orthopedics Department of the 901st Hospital from Jan. 2019 to Dec. 2022, all of whom were fixed with patellar concentrators. According to the different methods of intraoperative fracture reduction, the patients were divided into 43 cases of the experimental group (using absorbable double thread purse string suture method) and of the control group (using Kirschner wire to maintain reduction). The surgical time, fracture healing time, knee joint function score at the last follow-up, and incidence of postoperative complications between two groups. Results All patients successfully completed the surgery and were followed up for 4 to 18 months, with an average of （12.23±4.50） months. There was no statistically significant difference in the healing time between the two groups of fractures（P=0.290） .The surgical time of the experimental group was shorter than that of the control group, and the excellent and good rate of Bostman function evaluation of the knee joint was higher than that of the control group at the last follow-up, and the differences were statistically significant（P< 0.05） . Both groups of patients had primary healing of incisions, with no complications such as skin edge necrosis, fracture re displacement, loosening of patellar concentrators, and non union of fractures. Conclusions The combination of absorbable double strand suture and patellar concentrator fixation in the treatment of patellar comminuted fractures is more conducive to intraoperative reduction of fractures, reduction of surgical time, and recovery of knee joint function, which is worthy of clinical application.