髌骨骨折的手术方法探讨

目的分析比较改良式张力带内固定与镍钛聚髌器手术治疗髌骨骨折的临床疗效和应用价值。方法回顾性分析收治的髌骨骨折患者84例。随机分为两组,治疗组采用改良式张力带内固定手术治疗;对照组采用镍钛聚髌器固定手术治疗。对两组临床资料和治疗效果进行分析比较。结果治疗组优良率为95.24%;对照组优良率92.86%。临床疗效两者无明显差异,两组术后平均下床时间、术后平均正常行走时间、膝关节达90°平均时间、临床愈合时间无明显差异(P>0.05),治疗组手术时间和二次手术时间明显短于对照组(P<0.05),费用-效用明显优于对照组(P<0.05)。结论改良式张力带内固定手术治疗髌骨骨折手术简单、操作安全、固定牢靠、创伤小、费用低。值得临床进一步推广。

Surgical operation approaches to patella fractures

Objective To analyze the clinical effectiveness and applied value of modified tension band fixation with nickel titanium patellar concentrator for patellar fractures.Methods A retrospective analysis was performed on 84 patients with patella fracture.All patients were randomly divided into two groups.The treatment group(42 cases) was treated by modified tension band fixation,and control group(42 cases) was given nickel titanium patellar concentrator fixation.The clinical data and therapeutic effectiveness were compared.Results The excellent and good rate in the treatment group and control group was 95.24% and 92.86%,respectively(P>0.05).There was no significant difference in mean postoperative ambulation time,mean postoperative normal walking time,average time of the knee joint 90° and the average time to clinical healing between two groups(P<0.05).The operating time and re-operating time in the treatment group were significantly shorter,and cost-effectiveness ratio was lower in the treatment group than in the control group(all P<0.05).Conclusion The modified tension band for patellar fracture internal fixation has the advantages of simple operation,safe manipulation,reliable fixation,little trauma,and low cost.