何嘉承 李强 周欢斌 喻巍 万良弈 傅江明

[摘要] 目的 比較髌骨粉碎性骨折髌骨环和克氏针张力带治疗的临床疗效。 方法 回顾性选取2014年1月至2020年1月我院治疗的髌骨粉碎性骨折患者60例，依据治疗方法分为髌骨环内固定组（n=30）和克氏针张力带组（n=30），统计并分析两组的手术相关指标、临床疗效及术后并发症发生情况。 结果 髌骨环内固定组的手术时间短于克氏针张力带组，术中出血量少于克氏针张力带组，骨折愈合时间短于克氏针张力带组，差异有统计学意义（P<0.05）;但两组住院时间比较，差异无统计学意义（P>0.05）。髌骨环内固定组膝关节功能恢复的优良率为90.0%（27/30），高于克氏针张力带组的66.7%（20/30），差异有统计学意义（P<0.05）。髌骨环内固定组的术后并发症总发生率为3.3%（1/30），低于克氏针张力带组的26.7%（8/30），差异有统计学意义（P<0.05）。 结论 髌骨粉碎性骨折髌骨环内固定治疗的临床疗效较克氏针张力带内固定治疗更为显著。

[关键词] 髌骨粉碎性骨折;克氏针张力带;髌骨环;并发症

[中图分类号] R683.42          [文献标识码] B          [文章编号] 1673-9701（2021）08-0079-04

Comparison of clinical efficacy between patellar ring and Kirschner wire tension band in the treatment of comminuted fracture of patella

HE Jiacheng   LI Qiang   ZHOU Huanbin   YU Wei   WAN Liangyi   FU Jiangming

Department of Orthopedics， Jiujiang No.1 People′s Hospital in Jiangxi Province， Jiujiang   332000， China

[Abstract] Objective To compare the clinical efficacy of patellar ring and Kirschner wire tension band in the treatment of comminuted patellar fracture. Methods A total of 60 patients with comminuted fracture of patella treated in our hospital from January 2014 to January 2020 were retrospectively selected and divided into the patellar ring internal fixation group（n=30） and the Kirschner wire tension band group （n=30） according to different treatment methods. The operative indicators， clinical efficacy and postoperative complication rate of the two groups were statistically analyzed. Results The operative time in the patella ring internal fixation group was significantly shorter than that in the Kirschner wire tension band group， the intraoperative blood loss in the patella ring internal fixation group was significantly less than that in the Kirschner wire tension band group and the fracture healing time in the patella ring internal fixation group was significantly shorter than that in the Kirschner wire tension band group（P<0.05）. But there was no statistically significant difference in hospitalized time between the two groups（P>0.05）. The excellent and good rate of functional rehabilitation of knee joint was 90.0%（27/30） in the patellar ring internal fixation group， which was significantly higher than 66.7% （20/30） in the Kirschner wire tension band group （P<0.05）. The postoperative complication rate was 3.3% （1/30） in the patellar ring internal fixation group， which was significantly lower than 26.7%（8/30） in the Kirschner wire tension band group（P<0.05）. Conclusion The clinical efficacy of patella ring internal fixation in the treatment of comminuted fracture of patella is more significant than that of Kirschner wire tension band internal fixation.

[Key words] Comminuted fracture of patella; Kirschner wire tension band; Patellar ring; Complication

约1%的骨折为髌骨骨折，20～50岁人群高发，和女性相比，男性发病率较高[1]。直接或间接外力是髌骨骨折的主要诱发因素，其中主要为直接暴力[2]。现阶段，克氏针张力带内固定是临床治疗髌骨骨折的常用方法，其原理为屈膝时转化张力为压力，临床根据适应证恰当选择治疗方法，能够减轻固定并良好复位髌骨骨折[3]，对于髌骨粉碎性骨折的治疗，应注意尽量多地保留骨折块，以对髌骨力臂进行有效维持[4]。因此，很多相关医学学者尝试寻找新的内固定方法，以对该治疗方法的不足进行有效弥补。本研究统计分析了2014年1月至2020年1月我院髌骨粉碎性骨折患者60例的临床资料，比较髌骨粉碎性骨折髌骨环内固定和克氏针张力带内固定治疗的临床疗效，现报道如下。……