张力带别针结合钢缆内固定与空心钉结合钢丝张力带内固定治疗髌骨横形骨折的比较研究

目的：比较张力带别针结合钢缆内固定和空心钉结合钢丝张力带内固定治疗髌骨横形骨折的临床疗效与安全性.方法：回顾性分析67例髌骨横形骨折患者的病例资料,其中采用张力带别针结合钢缆内固定33例（观察组）,采用空心钉结合钢丝张力带内固定34例（对照组）;横断骨折32例,上极骨折16例,下极骨折11例,粉碎性骨折8例.比较2组患者的手术时间、骨折愈合时间、术后并发症的发生情况及患者满意度情况.参照B（o）stman髌骨骨折疗效评分标准评定2组患者的临床疗效.结果：①一般指标.观察组患者的手术时间小于对照组（40.80±27.50） min,（42.50±23.30） min,t=7.151,P=0.042];2组患者骨折愈合时间比较,差异无统计学意义（12.09±1.77）min,（12.51±1.21） min,t=6.823,P=0.062].②临床疗效与患者满意度.观察组优28例、良4例、可1例,对照组29例、良3例、可2例.2组患者临床疗效比较,差异无统计学意义（Z=0.000,P=1.000）.观察组患者满意27例、基本满意4例、不满意2例,对照组患者满意25例、基本满意5例、不满意4例.2组患者满意度比较,差异无统计学意义（Z=-0.853,P=0.394）.结论：对于闭合性髌骨横形骨折患者而言,虽然张力带别针结合钢缆内固定与空心钉结合钢丝张力带内固定在骨折愈合时间、临床疗效、患者满意度及安全性方面无明显差异,但张力带别针结合钢缆内固定具有操作简单、手术时间短的优点,是治疗髌骨横形骨折的一种较理想的方法,值得临床推广应用.

A retrospective trial of internal fixation with tension band pin and wirerope versus hollow nail and steel-wire tension band in the treatment of patellar transverse fractures

Objective ：To compare the clinical curative effects and safety of internal fixation with tension band pin and wirerope versus hollow nail and steel-wire tension band in the treatment of patellar transverse fractures. Methods ： The medical records of 67 patients with patellar transverse fracture were analyzed retrospectively. Thirty-three patients （ observation group） were treated with internal fixation with tension band pin and wirerope, while the others （control group）were treated with internal fixation with hollow nail and steel-wire tension band. The fractures belonged to transverse fractures （ 32 ）, upper polar fractures （ 16 ）, lower polar fractures （ 11 ） and comminuted fractures （8）. The two groups were compared with each other in such parameters as operative time, fracture healing time, postoperative complications and satisfaction degree of the patients. The clinical curative effects were evaluated according to B~stman patellar fracture efficacy criteria. Results ： The operative time of observation group were less than that of control group （40.80 ＋/- 27.50 vs 42.50 ＋/- 23.30 min, t = 7.151, P = 0. 042） and there was no statistical difference in the fracture healing time between the 2 groups （ 12.09 ＋/- 1.77 vs 12.51 ＋/- 1.21 min, t = 6. 823, P = 0. 062 ）. Twenty-eight patients obtained an excellent result,4 good and 1 fair in the observation group, while 29 patients obtained an excellent result,3 good and 2 fair in the control group. There was no statistical difference in the clinical curative effects between the 2 groups （ Z = 0. 000, P = 1. 000 ）. Twenty-seven patients were satisfied with the results,4 basically satisfied and 2 unsatisfied in the ob- servation group;while twenty-five patients were satisfied with the results,5 basically satisfied and 4 unsatisfied in the control group. There was no statistical difference in the satisfaction degree of the patients between the 2 groups （Z = -0. 853, P = 0. 394 ）. Conclusion：There are no significant d