CAJ | 학술논문

背景：以往采用张力带钢丝或钢丝环扎、镍钛聚髌器结合可吸收线、双环10号丝线环扎并分体式髌骨爪及记忆合金聚髌器治疗髌骨粉碎骨折时，难以达到髌骨骨折的坚强固定。 　　目的：探讨聚酯编织线缝扎结合带锁扣线缆环扎治疗严重髌骨粉碎性骨折的临床效果。 　　方法：回顾性分析2007年1月至2012年10月采用聚酯编织线缝扎结合带锁扣线缆环扎治疗的57例髌骨粉碎性骨折患者临床资料。根据AO分型，B3型9例，C2型22例，C3型26例。手术中确定髌骨满意复位后，先用粗聚酯编织线间断缝合两侧股四头肌扩张部，间断缝合骨膜及髌前组织，应用带锁扣线缆环扎固定，视骨折块稳定情况，用粗聚酯编织线在髌前组织行“8”字张力带固定。术后根据 Bostman 髌骨骨折临床评估标准评估疗效。 　　结果与结论：46例获得4-18个月随访，骨折愈合时间3-5个月；伤口均Ⅰ期愈合，无感染发生，骨折全部愈合，无钛缆松脱和皮肤刺激等并发症。按Bostman髌骨骨折疗效评分标准，优33例，良10例，可3例，优良率为93.5%。表明聚酯编织线缝扎结合带锁扣线缆环扎治疗严重髌骨粉碎性骨折能使骨折块紧密接触，固定可靠，可行早期功能锻炼。
배경：이왕채용장력대강사혹강사배찰、얼태취빈기결합가흡수선、쌍배10호사선배찰병분체식빈골조급기억합금취빈기치료빈골분쇄골절시，난이체도빈골골절적견강고정。 　　목적：탐토취지편직선봉찰결합대쇄구선람배찰치료엄중빈골분쇄성골절적림상효과。 　　방법：회고성분석2007년1월지2012년10월채용취지편직선봉찰결합대쇄구선람배찰치료적57례빈골분쇄성골절환자림상자료。근거AO분형，B3형9례，C2형22례，C3형26례。수술중학정빈골만의복위후，선용조취지편직선간단봉합량측고사두기확장부，간단봉합골막급빈전조직，응용대쇄구선람배찰고정，시골절괴은정정황，용조취지편직선재빈전조직행“8”자장력대고정。술후근거 Bostman 빈골골절림상평고표준평고료효。 　　결과여결론：46례획득4-18개월수방，골절유합시간3-5개월；상구균Ⅰ기유합，무감염발생，골절전부유합，무태람송탈화피부자격등병발증。안Bostman빈골골절료효평분표준，우33례，량10례，가3례，우량솔위93.5%。표명취지편직선봉찰결합대쇄구선람배찰치료엄중빈골분쇄성골절능사골절괴긴밀접촉，고정가고，가행조기공능단련。
BACKGROUND:Serious patel ar comminuted fractures can be treated by a number of methods such as cerclage with tension band steel wire or steel wire, or fixation with the nickel titanium patel a concentrator and absorption lines, or cerclage with 10# double-loop wire plus fixation with split-type patel a claws or with the memory al oy patel a concentrator. But it is difficult to achieve strongly fixed effect on patel a fractures by these methods. OBJECTIVE:To investigate the clinical effects of suture with polyester braided wire and cerclage with belt lock cable on serious comminuted patel ar fractures. METHODS:A retrospective analysis was performed on the clinical data of 57 patients with serious comminuted patel ar fractures who received suture with polyester braided wire and cerclage with belt lock cable from January 2007 to October 2012. According to AO classification of fractures, there were nine cases of type B3, 22 cases of type C2 and 26 cases of type C3. After satisfactory reduction of comminuted patel ar fractures during the operation, firstly we sewed up both sides of the expansion region of quadriceps muscle and stitched on periosteum and prepatel ar tissue with thick polyester braided wire fol owed by patel ar cerclage with belt lock cable. According to the stability of fracture blocks, tension band fixation with polyester braided wire was partial y added. After the operation, the clinical effects were assessed based on the Bostman score system. RESULTS AND CONCLUSION:Total y 46 out of 57 cases were fol owed up with an average of 8 months (4-18 months). Al patients obtained bone union within 3-5 months. Wounds healed in the first stage without any infections, and fractures in al patients healed without complications such as implant loosening and skin irritation. According to the Bostman score system, 33 cases were scored excellent, 10 good and three fair. The excellent and good rate was 93.5%. It suggests that treatment of serious patel ar comminuted fracture by the combination of polyester braided wire and belt lock cable leads to closely contact fracture sites and reliably fix bone fragments. It can facilitate early postoperative range of motion exercises.