纽扣式缝合在固定髌骨粉碎性骨折游离软骨块中的应用*

目的 探讨纽扣式缝合在固定髌骨粉碎性骨折游离软骨块中的应用及临床疗效。方法 使用纽扣式缝合技术辅助固定髌骨粉碎性骨折游离软骨块患者15例，术后影像学评估骨折复位，临床采用患膝关节活动度和Böstman髌骨骨折功能评分评估关节功能。结果 15例患者均获得6 ～ 18个月随访，术后伤口均愈合良好，X线平片及膝关节CT检查骨折对位、对线良好，关节面平整。术后6个月随访X线片显示骨折均骨性愈合，未见骨块脱落及创伤性关节炎; 术后6个月膝关节活动度屈曲平均为（128.00±5.39）°（116° ～ 135°），伸平均为（2.00±1.31）°（-2° ～ 6°）; Böstman髌骨骨折功能评分平均为29分，其中优13例，良2例，优良率为100%。结论 纽扣式缝合能有效固定髌骨骨折中的游离软骨块，术后可早期行康复功能锻炼，未见游离骨块脱落，临床疗效满意。

Application of button suture in the fixation of free cartilage block of comminuted patella fracture

Objective To investigate the application and clinical effect of button suture in the fixation of free cartilage of comminuted patella fracture. Methods Fifteen patients with comminuted patellar fracture were treated with button suture technique. The fracture reduction was evaluated by postoperative imaging, and the joint function was evaluated by knee range of motion and Böstman patellar fracture function score. Results All 15 patients were followed up for 6 to 18 months. All the wounds healed well after operation. X-ray film and CT examination showed that the fracture alignment and alignment were good, and the articular surface was smooth. After 6 months follow-up, X-ray film showed that all fractures healed without bone mass shedding and traumatic arthritis; the average flexion and extension of knee joint was (128.00±5.39)° (116°-135°) and (2.00±1.31)° (-2°-6°); the average Böstman score of patellar fracture function was 29 points, in which 13 cases were excellent and 2 cases were good, and the excellent and good rate was 100%. Conclusion Button suture can effectively fix the free cartilage mass in patella fracture, and early rehabilitation exercise can be performed after operation, and no free bone mass is shed. The clinical effect is satisfactory.