CAJ | 학술논문

目的探讨一种操作简单、疗效可靠的治疗髌骨骨折手术方式.方法髌骨骨折108例,男76例,女32例;年龄18～82岁,平均43岁.右侧骨折67例,左侧4l例.横断型骨折43例,粉碎型骨折54例,撕脱型骨折8例,纵型骨折3例.伤后至手术时间3 h～10 d.术中显露髌骨,复位,巾钳临时固定,用双股可吸收缝线编织一个五角星,呈网状置于髌骨前.用缝线穿过五角星的5个角,做双半环髌骨周围缝合,固定髌骨.这种称为"五角网缝合术"方法属张力带固定.实验采用20具新鲜牛膝关节,髌骨横断骨折,完全随机分成A、B两组,分别用五角网缝合术和AO张力带缝合术固定,在MTS试验机上对股四头肌进行加载测试,得出不同负荷(0～500 N)下骨折端分离距离.结果 108例髌骨骨折术后随访6～60个月,平均20个月,骨折均愈合.按Bost-man髌骨骨折疗效评价标准,优76例,良32例.力学试验表明,采用五角网缝合术和AO张力带缝合术的髌骨骨折端分离距离差异无统计学意义(P>0.05) 结论五角网缝合术治疗髌骨骨折,具有操作简单、固定牢固、术后可早期活动、康复快、疗效确切、无须二次手术取内固定等优点.
목적 탐토일충조작간단、료효가고적치료빈골골절수술방식.방법 빈골골절108례,남76례,녀32례;년령18～82세,평균43세.우측골절67례,좌측4l례.횡단형골절43례,분쇄형골절54례,시탈형골절8례,종형골절3례.상후지수술시간3 h～10 d.술중현로빈골,복위,건겸림시고정,용쌍고가흡수봉선편직일개오각성,정망상치우빈골전.용봉선천과오각성적5개각,주쌍반배빈골주위봉합,고정빈골.저충칭위"오각망봉합술"방법속장력대고정.실험채용20구신선우슬관절,빈골횡단골절,완전수궤분성A、B량조,분별용오각망봉합술화AO장력대봉합술고정,재MTS시험궤상대고사두기진행가재측시,득출불동부하(0～500 N)하골절단분리거리.결과 108례빈골골절술후수방6～60개월,평균20개월,골절균유합.안Bost-man빈골골절료효평개표준,우76례,량32례.역학시험표명,채용오각망봉합술화AO장력대봉합술적빈골골절단분리거리차이무통계학의의(P>0.05) 결론오각망봉합술치료빈골골절,구유조작간단、고정뢰고、술후가조기활동、강복쾌、료효학절、무수이차수술취내고정등우점.
Objective To explore a simple and effective operative procedure for treatment of pa-tellar fractures.Methods The clinical data of 108 patients (including 76 males and 32 females) with patellar fractures were analyzed.The age of the patients ranged from 18 years to 82 years.There were 67 patellar fractures on the right extremities and 41 on the left.Fracture types included transfractures in 43 patients, comminuted fractures in 54, torn fractures in eight and longitudinal fractures in three.Period from injury to operation ranged from 3 hours to 10 days.During operation, the broken patella was exposed for reduction and temporary pliers fixation;then, a five-pointed star woven with two absorbable sutures was placed on the broken patella, two semi-circular sutures around the patellar edge were made with su-tures which were through five points of the five-pointed star.When two sutures were pulled and knotted,the five-pointed star was also stretched to fix the patellar fractures firmly.Models of transverse patellar fractures were made in 20 knee joints of catties, which were divided into two groups randomly.Patellar fractures in Group A were fixed with five-pointed star lattice sutures and those in Group B with AO inten-sion bands.Loading test was performed on quadriceps femoris with materials test system for measuring the width of each fractured patella after the test.Results All patients were followed up for 6-60 months (mean 20 months) , which showed that all patellar fractures were healed.According to Bostman scoring system, the efficacy was excellent in 76 patients and good in 32.The experiment showed no statistical difference in the fracture disjunction distance between two methods (P > 0.05).Conclusion For treatment of patellar fractures, five-pointed star lattice sutures have the advantages of simple operation,reliable fixation, early postoperative exercise, fast recovery, satisfactory outcome and free need of reoper-ation for removing internal fixation.