【摘要】：[目的]探討運(yùn)用愛惜邦行髕韌帶編織固定,結(jié)合鈦纜捆扎技術(shù)治療老年骨質(zhì)疏松性髕骨下極骨折的臨床療效。[方法]回顧性分析2014年1月~2015年9月本院收治入院的42例老年髕骨下極骨折患者資料,男18例,女24例,年齡59~72歲,閉合骨折38例,開放骨折4例(均為Gustilo I型骨折)。受傷至手術(shù)時間平均為2.8 d(8 h~5 d)。術(shù)中先采用愛惜邦對髕韌帶編織縫合后復(fù)位骨折,經(jīng)骨隧道固定于髕骨上極,再結(jié)合鈦纜環(huán)扎固定,必要時加用張力帶固定。術(shù)后隨訪觀察骨折愈合時間及膝關(guān)節(jié)功能,采用Bostman髕骨骨折功能評分標(biāo)準(zhǔn)評定患肢功能。[結(jié)果]術(shù)后患者隨訪8~28個月(平均18個月),骨折愈合時間9~12周,無伸膝無力、無內(nèi)固定移位及斷裂者。術(shù)后8個月按照Bostman髕骨骨折功能評分:平均28.9分,其中優(yōu)33例,良9例,優(yōu)良率100%。膝關(guān)節(jié)穩(wěn)定性良好,末次隨訪膝關(guān)節(jié)平均活動度:伸直-1°,屈曲127°。所有患者股四頭肌力5級,行走恢復(fù)至術(shù)前狀態(tài)。[結(jié)論]線纜固定技術(shù)可有效的治療老年髕骨下極骨折,固定牢固可靠,特別適用于髕骨下極骨塊較小、骨質(zhì)疏松的患者,有利于術(shù)后早期進(jìn)行膝關(guān)節(jié)功能鍛煉,避免關(guān)節(jié)僵硬,是治療老年髕骨下極骨折一個簡便可行的方法。
[Abstract]:[objective] to explore the clinical effect of patellar ligament braiding fixation combined with titanium cable binding technique in the treatment of senile osteoporotic fracture of the inferior pole of patella. [methods] from January 2014 to September 2015, 42 elderly patients with fracture of the inferior pole of patella were analyzed retrospectively. There were 18 males and 24 females, aged 59 to 72 years old, 38 cases of closed fractures and 4 cases of open fractures (all of them were Gustilo I fractures). The average time from injury to operation was 2.8 days (8 hours to 5 d). During the operation, the patellar ligament was stitched and then the fracture was reattached. The fracture was fixed through the bone tunnel to the superior pole of the patella, and then fixed with the titanium cable. If necessary, the tension band was used to fix the fracture. The time of fracture healing and the function of knee joint were observed after operation. The function of the affected limb was evaluated by Bostman patellar fracture function scoring standard. [results] the patients were followed up for 8 months and 28 months (mean 18 months). The fracture healing time was 9 to 12 weeks. There was no weakness of knee extension, no internal fixation displacement and fracture. According to the Bostman patellar fracture function score at 8 months after operation, the average score was 28.9, in which 33 cases were excellent, 9 cases were good, and the excellent and good rate was 100%. The stability of knee joint was good. The mean range of motion in the last follow-up was-1 擄and 127 擄respectively. All patients with quadriceps femoris muscle strength level 5, walking restored to preoperative state. [conclusion] the technique of cable fixation can effectively treat the fracture of the inferior pole of the patella in the elderly, and the fixation is firm and reliable. It is especially suitable for the patients with small bone mass of the inferior pole of the patella and osteoporosis, which is beneficial to the early functional exercise of the knee after operation. To avoid joint stiffness is a simple and feasible method to treat the fracture of the inferior pole of patella in the elderly.
【作者單位】： 東南大學(xué)附屬中大醫(yī)院創(chuàng)傷骨科;
【基金】：國家自然科學(xué)基金資助項目(編號:81572188)
【分類號】：R687.3

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