关节镜下治疗髌骨骨折42例

目的探讨关节镜治疗髌骨骨折的疗效.方法应用关节镜技术治疗单纯新鲜髌骨骨折42例,在关节镜下清理关节内血凝块,对骨折进行复位、固定,经皮平行打入2枚克氏针固定骨折块,皮下导入钢丝行改良张力带固定.结果手术时间1.2～3 h,平均2.2 h.骨折愈合时间7～10周,平均7.5周.术后住院时间7～14 d,平均8.5 d.37例随访6个月～4年,平均19.2月,骨折全部愈合,无关节不稳和创伤性关节炎.疗效优34例,良2例,可1例,优良率97.3%(36/37).结论关节镜下内固定术治疗髌骨骨折,具有关节面复位好,固定牢固,创伤小可早期功能锻炼,术后功能恢复好等优点.

Treatment of patella fracture under arthroscope

Objective To study the efficacy of arthroscopy in the management of patella fracture.Methods Arthroscopic techniques were employed for treating 42 patients with fresh simple patella fracture.After blood clots and fragments were cleaned up,the fracture was reduced by manipulation.Two Kirschner's pins were parallelly inserted percutaneously for internal fixation of the fracture.Then a modified tension band fixation with percutaneous wire interposition was made.Results The operation time was(1.2~3) hours(mean,2.2 hours).The time to bone union was 7~10 weeks(mean,7.5 weeks).The postoperative hospital stay was 7~14 days(mean,8.5 days).Follow-up checkups in 37 patients for 6 months ~ 4 years(mean,19.2 months) revealed bone union in all the patients and no joint instability or traumatic arthritis.The curative results were classified as excellent in 34 patients,good in 2 patients,and fair in 1,the rate of excellent or good results being 97.3%(36/37).Conclusions Arthroscopic management of patella fracture has advantages of accurate reduction and fixation,little invasion,early postoperative functional training,and quick recovery.