CAJ | 학술논문

目的探讨应用Cable-pin系统治疗髌骨下极骨折的临床疗效. 方法 2009年6月至2011年2月采用Cable-pin系统治疗35例新鲜髌骨下极骨折患者,男19例,女16例；年龄35～74岁,平均51.4岁.致伤原因:交通伤4例,自行摔伤26例,运动伤5例.受伤至手术时间为0～7d,平均2.4d.术中骨折复位后先通过缝合恢复髌骨外形,然后再应用Cable-pin系统进行“8”字固定,必要时加行钢缆环形固定.术后随访观察患者骨折愈合情况和膝关节活动范围,采用Bostman髌骨骨折功能评分标准评定患肢功能. 结果 35例患者术后获平均10.2个月(6～15个月)随访.术后3个月随访无内固定失败患者,术后6个月随访所有患者骨折均获骨性愈合.术后6个月Bostman髌骨骨折功能评分平均为29.4分,其中优29例,良6例,优良率为100％.膝关节稳定性良好,末次随访时关节活动度:伸平均为-0.5°,屈平均为124.0°.所有患者患肢股四头肌肌力为5级.2例患者有皮下触痛,内固定物取出后消失. 结论 Cable-pin系统治疗髌骨下极骨折具有初始稳定性好、术后患者可早期进行功能锻炼及并发症少等特点,临床疗效满意.
목적 탐토응용Cable-pin계통치료빈골하겁골절적림상료효. 방법 2009년6월지2011년2월채용Cable-pin계통치료35례신선빈골하겁골절환자,남19례,녀16례；년령35～74세,평균51.4세.치상원인:교통상4례,자행솔상26례,운동상5례.수상지수술시간위0～7d,평균2.4d.술중골절복위후선통과봉합회복빈골외형,연후재응용Cable-pin계통진행“8”자고정,필요시가행강람배형고정.술후수방관찰환자골절유합정황화슬관절활동범위,채용Bostman빈골골절공능평분표준평정환지공능. 결과 35례환자술후획평균10.2개월(6～15개월)수방.술후3개월수방무내고정실패환자,술후6개월수방소유환자골절균획골성유합.술후6개월Bostman빈골골절공능평분평균위29.4분,기중우29례,량6례,우량솔위100％.슬관절은정성량호,말차수방시관절활동도:신평균위-0.5°,굴평균위124.0°.소유환자환지고사두기기력위5급.2례환자유피하촉통,내고정물취출후소실. 결론 Cable-pin계통치료빈골하겁골절구유초시은정성호、술후환자가조기진행공능단련급병발증소등특점,림상료효만의.
Objective To investigate the feasibility and clinical efficacy of Cable-pin technique for fractures of patellar inferior pole.Methods From June 2009 to February 201 1,35 patients with fresh patellar inferior pole fracture ( 19 males and 16 females,35 to 74 years of age,with an average of 51.4 years)were treated with Cable-pin technique.There were 4 cases of traffic injury,26 cases of falling injury and 5 cases of sports injury.The average time from injury to surgery was 2.4 days (from 0 to 7 days).The patellar contour was first restored by sutures after fracture reduction,followed by figure-of-8 fixation with Cable-pin technique,and wire ring fixation if necessary.The Bostman evaluation system,follow-up X-ray,and knee mobility were used to analyze the clinical efficacy of Cable-pin technique.Results All patients obtained a mean follow-up of 10.2 months (from 6 to 15 months).No internal fixation failure was observed 3 months post-surgery and bony union was achieved in all cases 6 months post-surgery.The mean Bostman functional score for patellar fractures was 29.4 points 6 months post-surgery.There were 29 excellent cases and 6 good ones with a good to excellent rate of 100％.The knee stability was fine in all cases.The ranges of motion at the last follow-up were:average extension of -0.5° degree and average flexion of 124.0°.All patients obtained muscle strength of Grade 5 for the quadriceps femoris of the affected limb.Two patients suffered subcutaneous tenderness which disappeared after removal of internal implants.Conclusion Cable-pin technique is a good alternative treatment of inferior fracture of the patella,because it can provide excellent initial stability and lead to early rehabilitation exercise and limited complications.