锚钉结合减张线法治疗髌骨下极撕脱性骨折

目的：探讨应用锚钉结合减张线法治疗髌骨下极撕脱性骨折的方法和技术要点,并评价其临床疗效。方法：采用尾端带线锚钉结合减张线法治疗13例髌骨下极粉碎性骨折患者,女8例,男5例;年龄48-73岁,平均（61.1±7.1）岁;伤后至手术时间1-17 d,平均（4.9±4.8）d。采用Bostman髌骨骨折疗效临床评分标准评定术后优良率。结果：患者均获得随访,随访时间6-33个月,平均（15.2±8.6）个月。除l例患者出现伤口脂肪液化延迟愈合外,其余患者切口愈合良好。术后3个月随访摄X线片显示髌骨骨折愈合良好,锚钉无松动、脱落。术后6个月Bostman髌骨骨折功能评分（28.5±1.6）分。优10例,良3例,优良率100%。结论：锚钉结合减张线技术治疗髌骨下极撕脱性骨折创伤小、手术操作简单、固定可靠,无需二次手术取出内置物,是治疗髌骨下极撕脱性骨折的一种有效的手术方法。

Suture anchors combined with tension sutures in the treatment of avulsion fractures of inferior patellar pole

Objective： To investigate the treatment methods and techniques of avulsion fractures of inferior patellar pole with suture anchors combined with tension sutures, and to evaluate the clinical effect. Methods： A group of 13 patients , 8 females and 5 males, with avulsion fractures of inferior patellar pole were treated with suture anchors combined with tension sutures. The average age was （61.1±7） （ranging from 48 to 73）years; The interval period from injury to operation was （4.9±4.8） （ranging from 1 to 17） days. All the patients were regularly followed up using the Bostman patellar fracture scoring system to evaluate the clinical effect. Results： All cases were followed up for average （15.2±8.6） （ranging from 6 to 33） months. The delayed healing due to fat liquefaction occurred in 1 patient, with all the other patients incision healing well. After 3 months of follow-up, X-ray examination revealed the healing of avulsion fracture, with no occurrence of loosening or dropping anchor. The Bostman score was 28.5±1.6 after 6 months postoperatively with excellent in 10 cases, good in 3 cases and the excellent/good rate being 100%. Conclusion：The method enhances the healing of the wound with simple technique and provides strong fixation with minimal dissection. Furthermore, removing internal fixation devices is avoided, it is an effective operation method for avulsion fractures of inferior patellar pole.