钢丝双褥式缝合治疗老年髌骨下极粉碎性骨折

目的:探讨应用钢丝双褥式缝合治疗老年髌骨下极粉碎性骨折的可行性。方法:自2002年2月至2009年3月,我院运用钢丝双褥式缝合治疗髌骨下极粉碎性骨折38例,其中60岁以上患者21例。本组均为骨折块6块以上,大多数骨折块小于10mm~2的严重粉碎性骨折,根据王Rockwood髌骨骨折分型均为V型骨折,采用钢丝双褥式缝合进行治疗,根据陆裕朴等评定标准对其疗效进行评定。结果:21例老年患者均获得(12～31)个月(平均15个月)随访,所有患者无伤口感染以及软组织激惹,骨折均愈合良好(平均愈合时间3个月)。根据陆裕朴等疗效评定标准,优18例,良1例,可2例,优良率90.5%。结论:对老年髌骨下极粉碎性骨折,尤其是髌骨下极粉碎严重,无法行克氏针张力带予以有效固定者,钢丝双褥式缝合法可有效的保留髌骨的长度,避免髌骨下极切除引起伸膝无力,减少髌股关节炎以及(错格)现象的发生,较少的内固定物有效的减轻了软组织激惹。

Double Mattress Wire Suture in Treating Senile Patients with Inferior Polar Fracture of Patella

Objective:To evaluate the double mattress suture wire treatment of senile fractures of the inferior pole of patella viability.Methods: Since February 2002 to March 2009,our hospital mattress suture using two-wire treatment of lower pole of patella fracture in 38 cases,of which 21 patients aged over 60.Fractures in this group were more than six blocks,most of the serious fiacture comminuted fracture of the block is less than 10mm, according to Wang Rockwood V patella fiactures are fiacture type,with steel wire double mattress suture for treatment,according to evaluation criteria such as Lu Yu Pu evaluation of its efficacy.Results:21 cases of elderly patients were 12 to 31 months(mean 15 months) follow-up,all patients without wound infection and soft tissue irritation,fractures healed well(average healing time of 3 months).According to Lu Yu Pu and other evaluation standard, excellent in 18 cases,good in 1 case and 2 cases,the fine rate was 90.5%.Conclusion:The lower pole of patella fiactures in elderly,especially in the lower pole of the patella serious crush,the line tension band can not be effectively fixed by steel wire double mattress suture method can effectively keep the length of the patella to prevent removal of the lower pole of the patella caused by extension knee weakness,reduced patellofemoral arthritis,and(the wrong cell) phenomenon,less effectively reduce the internal fixation of soft tissue irritation.