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改良微创入路治疗髌骨横行骨折
宋绍军,毛宁方,曹烈虎,翁蔚宗,苏佳灿*
0
(第二军医大学长海医院骨科, 上海 200433
*通信作者)
摘要:
研究背景 越来越多的骨科医生选择微创治疗髌骨横行骨折,因为术后切口美观,并发症少,功能恢复又快又好,能早期工作,对工作和生活影响小。目的 探讨超声介导股神经阻滞下自行设计的空心钉钛缆微创治疗年轻患者髌骨横行骨折的疗效,观察患者的手术切口,术中出血,术后功能等。方法 2009年02月至2012年06月,采用空心钉钛缆系统微创治疗30例髌骨横行骨折患者,男16例,女14例;年龄24-60岁,平均38.4岁。受伤机制:车祸伤10例,高处坠落伤6例,摔伤14例。骨折分型;上极骨折为6例,中部骨折11例,下极骨折13例。结果 所有患者切口均一期愈合,无感染病例,术后10天拆线。30例均获得随访,随访平均时间18月。骨折愈合平均时间6.8周,术后二周后恢复工作,膝关节伸曲活动良好,根据膝关节 Lysholom 功能评分,优27例,良3例,优良率100%。结论 空心钉钛缆系统微创治疗年轻患者髌骨横行骨折,固定可靠,符合生物力学要求,住院时间短,手术损伤小,并发症少,术后功能恢复良好,一种良好的治疗方法。
关键词:  cable-pin  髌骨横行骨折  改良入路  微创性外科手术
DOI:10.3724/SP.J.1008.2014.01280
投稿时间:2014-02-19修订日期:2014-09-12
基金项目:国家自然科学基金(31271031).
A modified mini-invasive approach for treatment of transverse patella fracture
SONG Shao-jun,MAO Ning-fang,CAO Lie-hu,WENG Wei-zong,SU Jia-can*
(Department of Orthopaedic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding authors)
Abstract:
183Background More clinicalSdoctors tend to choose minimally invasive treatments for patella fracture. Because patients have lower complications,better function and perfect incision,which makes them early continue working and influences a little on their careers and life. Objective To explore the efficacy of minimally invasive treatment of patella transverse of young people, we choose percutaneous cannulated screw and titanium cable that we design to operate surgery .we observe the surgical incision,hemorrhage and function Methods From February 2009 to June 2012, we applied the minimally invasive technique of percutaneous cannulated screw and titanium cable to treat 30 cases of patella transverse,16 males and 14 females. Aged 24-45years,mean 35.4years.injury mechanism:10 cases in the traffic accident,6 cases in the fall s injury, 14 cases in the kneeling injury. fracture type:6 cases proximal pole fracture ,11 cases middle pole fracture and 13 cases distal pole fracture. Result All patients healed incision. 30 cases were followed up for mean 18 months. Fracture healed in mean 6.8 weeks. According to Lysholom function score, excellent in 27 cases, good in 2 cases, good rate of 100%. Conclusion Minimally invasive technique of percutaneous cannulated screw and titanium cable to treat the patella transverse fracture is the better choice. I t fixes reliable ,follow the biomechanical and have low surgical damage. Patients have less complication and get a good clinical efficacy. It is a better choice to treat patella transverse fracture of young fracture.
Key words:  cable-pin  patella fracture  modified approach  minimally invasive surgical procedures