陈旧性髌骨骨折的综合治疗体会及探讨

目的：探讨陈旧性髌骨骨折的最佳治疗方案。方法：我院1997.1-2007.12收治陈旧性髌骨骨折患者20例,均采用术前髌骨牵引、股四头肌锻炼,术中髌前纵形S切口、改良张力带固定骨折块,配合关节腔注射玻璃酸钠,术后早期行患肢CPM机功能锻炼。结果：所有患者均获得随访,随访时间1.5-3.5年,平均2.2年。患者术后X片髌骨骨折块对位良好、关节面平整。术后切口甲级愈合,下床时间2d-21d,平均6.5d。骨折愈合时间3.0-6.5月,平均4.2月。术后1.5年膝关节HSS功能评分：优8例,良8例,可3例,差1例,优良率80%。结论：术前牵引、术中正确处理骨折、术后术后早期锻炼等综合治疗陈旧性髌骨骨折疗效显著。

Old Comprehensive Treatment of Patella Fractures Pxperience

Objective：To study the best treatment of old patella fracture.Methods：From January 1997 to December 2007,Twenty cases of old patella fracture were treated in our hospital,by using pre-operative patella traction,quadriceps exercise,intraoperative patellar anterior longitudinal S-shaped incision,fixation of fracture with modified tension band as well as articular cavity injection of sodium hyaluronate,early postoperative functional exercise in affected limb with CPM machine.Results：All patients were followed up for 1.5-3.5 years, averaged 2.2 years. X-ray showed that patients with patellar fracture have a good apposition, smooth articular surface, perfect postoperative wound healing, time for walking is 2-21days, an average is 6.5d. Fracture healing time is 3.0-6.5 months, an average is 4.2 months. 1.5 years after the surgery, HSS knee function score： excellent in 8 cases, good in eight cases, fine in 3 cases, and poor in 1 case, excellent and good rate is 80%. Conclusion： Preoperative traction, proper management of fracture during surgery, early postoperative exercise are comprehensive and effective treatment of old patella fractures.