关节镜下空心螺钉张力带内固定治疗髌骨骨折

目的介绍关节镜下应用空心螺钉张力带内固定治疗髌骨骨折的临床应用。方法 17例新鲜髌骨骨折,均为横行骨折,手术通过关节镜清理关节内血凝块,即时诊断和处理各种并发症,关节镜直视下指导骨折复位固定,经皮平行打入两枚克氏针固定骨折块,导入空心螺钉并用钢丝行张力带内固定治疗髌骨骨折。结果平均随访18.6个月,平均骨折愈合时间7.5周。结论关节镜下空心螺钉张力带内固定治疗髌骨骨折提供了一种新的治疗方法。具有创伤小,关节面复位好,固定牢固,能即时进行并发症的诊断和治疗,早期功能锻炼,术后功能恢复好等优点。

Clinical study on Treatment of Fractures of Patella by Arthroscopy and Percutaneous Modified Tension Band

Objective To introduce the clinical application of trentment of fractures of the patella by arthroscopy and percutaneous modified tension band.Methods Seventeen patients who suffered from fresh fractures of the patella were treated under arthroscopy,all of them were transverse fractures,The blood clot and fragments were irrigated with arthroscopy.The fractures were closed by manipulation and percutaneously applied towel clips,while assessing the conditions of the fracture with arthroscopy,two kirschners needles were inserted parallel to fracture fragments.Once these had accurately placed,the percutaneous tension band wires were made with small incisions.Results Thirty-eight cases were followed-up for 6～36 months,average of 18.6 months.Conclusion Arthroscopic management of fractures of the patella have the advantages of accurate reduction and fixtion,In addition there is less surgical exposure and complications.This has led to far less disability and discomfort,substantially shorter hospitalization and accelerated recovery.So arthroscopic management of fractures of the patella offers a new method for treatment of fractures of the patella.