髌骨骨折手术治疗与非手术治疗对比

目的 探讨髌骨骨折采用手术治疗和非手术治疗的优缺点。方法根据患者的X光片和手术中所见，将手术治疗组和保守治疗组各20例分为横断型和星状、粉碎型骨折两大类，分别采用切开复位张力带钢丝内固定和手法复位自制抱膝圈加石膏托外固定。两组均随访1年以上。结果对两大类型髌骨骨折的治疗结果满意度，手术治疗为80％，显著优于保守治疗的50％（P〈0．05）。但总有效率（疗效优＋疗效良）手术治疗为90％，保守治疗为95％，两法相比无显著差异（P〉0．05），其中对横断型骨折的治愈达优率，手术治疗为100％，保守治疗为50％；对星状、粉碎型骨折的治愈达优率，手术治疗为42．8％，保守治疗为58．2％，两法相比有显著差异（P〈0．05）。结论对横断型髌骨骨折（包括横断并碎裂为几大块的骨折），特别是断端分离超过2cm者，应该采用手术治疗；而对严重粉碎性骨折，主要考虑非手术治疗。

Surgical treatment of patellar fracture compared with non - surgical treatment

Objective to study the treatment of patella fracture and non - operate treated by operation of advantages and disadvantages. Methods According to patients x - rays and surgery, will be seen in treatment group and conservative surgical treatment group every 20 cases were divided into hengduan type and star shaped, crushing of fractures of two catego- ries, respectively by open redaction and internal fixation with wire tension gimmick reset homemade tuck circle 8dd cast external fixation. Both groups were followed up for one year or more. Results Two types of patella fracture of the treatment outcome satisfaction, surgical treatment for 80%, significantly better than 50% of conservative treatment （ P 〈 0. 05 ）. But the total effective rate （curative effect optimum ＋ curative effect good） surgery is 90% , conservative treatment compared with 95%, there no significant differences（ P 〉 0.05 ）, including the cure of cross - sectional of fractures of optimal rate, surgical treatment for 100%, conservative treatment for 50% of stellate, crushing of fractures of the cure of optimal rate, surgical treatment for 42.8%, conservative treatment for 58.2%, there are significant differences than （ P 〈 0.05 ）. Conclusion The hengduan type patella fracture （ including cross - sectional and rupture for large pieces of fracture）, especially cut ends separation over who should adopt 2cm surgical treatment ; For serious a commimuted fracture, main consideration nonoperative treatment.