三种不同内固定方法治疗髌骨骨折及对膝关节功能的影响

目的评价三种髌骨骨折内固定治疗效果及对膝关节功能的影响。方法手术治疗髌骨骨折120例,其中A组38例采用粗丝线或可吸收粗线环形缝合固定,B组44例采用AO改良张力带固定,C组38例采用镍钛聚髌器(NT-PC)固定。结果A、B、C三组膝关节活动度分别为71.05%、81.82%、89.47%;膝关节功能恢复优良率分别为84.21%、90.91%、97.37%。结论三种不同内固定方法可用于髌骨骨折的治疗,而后二种方法更佳,且缝合固定法由于不可避免的外固定,而在治疗近期可对膝关节造成一定的影响。

Treatment of Fractures of the Patella with Three Different Internal Fixation and Affection to Function of Knee Joints Involved due to the Treatment

Objective To evaluate prospectively the outcomes of the treatment of fractures of the patella with three different techniques of internal fixation of patella fractures and the affection to function of knee joints involved due to the treatment. Methods 120 cases suffered from close or open patella fractures without being infected after trauma from 2000 to 2004 with three different techniques of internal, fixation of patella fractures were divided into 3 groups. Group A (38 cases) were managed by thick silk or biodegradable line tension band circular suture technique. Group B (44 cases) by AO modified tension band fixing technique. Group C (38 cases) by Ni - Ti patellar concentrator fixation fixing technique. Results The rate of both the excellent and the good of Rom in group A , B and Cwas 71.05% , 81.82% and 89.47% , respectively. The rate of both the excellent and good of the outcomes of the function of knee joints in group A,B and Cwas 84.21% ,90.91% and 97.3% ,respectively. Conclusion Three different techniques of internal fixation of patella fractures is appropriate for treatment of close or open patella fractures after trauma, especially AO modified tension band fixing technique and Ni - Ti patellar concentrator fixation fixing technique. Yet thick silk or biodegradable line tension band circular suture technique could slightly affect the articular function of knee joints due to being accompanied by indispensable external fixation during early treatment.