髌骨固定针与克氏针张力带治疗髌骨骨折的病例对照研究

目的:比较髌骨固定针联合张力带钢丝与克氏针张力带治疗髌骨骨折的临床疗效。方法:回顾2010年11月至2012年1月采用髌骨固定针及克氏针张力带治疗髌骨骨折42例。髌骨固定针组21例,男14例,女7例,年龄26～65岁,平均43.6岁;克氏针组21例,男12例,女9例,年龄32～58岁,平均41.5岁。观察两组的手术时间、术中出血量、骨折愈合时间,并根据Bstman评价标准比较两组术后疗效。结果:所有患者获随访,时间6～14个月,平均11.5个月。两组骨折均愈合良好,无不愈合、感染等并发症。根据Bstman评价标准,两组疗效差异无统计学意义(Z=-0.83,P=0.407)。两组手术时间比较差异有统计学意义(t=6.670,P=0.000),术中出血量、骨折愈合时间差异无统计学差异(t=1.900,P=0.064;t=0.612,P=0.544)。结论:两组患者均取得满意疗效,但髌骨固定针联合张力带钢丝治疗髌骨骨折操作更简单,手术时间更短,固定牢固,并发症少,术后膝关节功能恢复好,是治疗髌骨骨折的有效方法之一。

Case-control study on patellar fixed pin and Kirschner's nail with tension band for the treatment of patellar fracture

Objective: To compare the clinical efficiency of patellar fixed pin and Kirschner's nail with tension band in treating patellar fracture. Methods: From November 2010 to January 2012,the clinical data of 42 patients with patella fracture were treated with patella fixed needle and Kirschner's nail with tension band. The patellar fixed needle group included 21 cases (14 males and 7 females,aged 26 to 65 with an average of 43.6 years old);The Kirschner's nail with tension band group included 21 cases(12 males and 9 females,aged 32 to 58 with an average of 41.5 years old). The operation time,intra-operative blood loss and healing time were compared between two groups. Böstman score was applied to compare the therapeutic effects. Results: All patients were followed up with an average of 11.5 months ranged from 6 to 14 months. The fractures healed well without complications such as nonunion and infection. According to Böstman score,there was no significant difference between two groups in clinical efficiency(Z=-0.83,P=0.407). There was significant difference in operation time (t=6.67,P=0.00),while no difference in intra-operative blood loss,bone healing time(t=1.90,P=0.064;t=0.612,P=0.544). Conclusion: Both methods can obtain good results. However,patellar fixed pin combined with tension band is one of the ideal methods for the treatment of patellar fracture,it has an advantage of simple with shorter operation time,rigid fixation,less complications and well recovery.