CAJ | 학술논문

背景:目前临床治疗髌骨骨折的内固定方法众多,但各有优缺点.内固定方法的选择是否合适,将直接影响髌骨骨折愈合时间及膝关节功能恢复.目的:评估空心拉力螺钉加镍钛聚髌器置入内固定治疗髌骨骨折后的生物力学重建效果.方法:回顾性分析2011年1月至2012年1月复旦大学附属金山医院骨科收治的新鲜髌骨骨折患者27例,横形骨折13例,粉碎骨折11例,上或下极骨折3例.采用空心拉力螺钉加镍钛聚髌器置入内固定,不需石膏外固定,内固定后自第2天开始行股四头肌主动收缩训练,内固定后1周开始床上屈伸膝关节锻炼.采用B?stman髌骨骨折疗效评定标准进行膝关节功能评价.结果与结论:27例患者均获随访,随访时间4-14个月.切口均获Ⅰ期愈合,无内固定断裂或脱落、切口感染、皮肤坏死等并发症.骨折平均愈合时间为8.5周,无延迟愈合发生.根据B?stman评分标准,平均分为27.9分,其中优22例(81%)、良4例(15%)、差1例(4%),优良率为96%.结果显示,在空心拉力螺钉的基础上辅以镍钛聚髌器固定兼具传统各种内固定方法之优点,同时避免了其不足之处.
배경:목전림상치료빈골골절적내고정방법음다,단각유우결점.내고정방법적선택시부합괄,장직접영향빈골골절유합시간급슬관절공능회복.목적:평고공심랍력라정가얼태취빈기치입내고정치료빈골골절후적생물역학중건효과.방법:회고성분석2011년1월지2012년1월복단대학부속금산의원골과수치적신선빈골골절환자27례,횡형골절13례,분쇄골절11례,상혹하겁골절3례.채용공심랍력라정가얼태취빈기치입내고정,불수석고외고정,내고정후자제2천개시행고사두기주동수축훈련,내고정후1주개시상상굴신슬관절단련.채용B?stman빈골골절료효평정표준진행슬관절공능평개.결과여결론:27례환자균획수방,수방시간4-14개월.절구균획Ⅰ기유합,무내고정단렬혹탈락、절구감염、피부배사등병발증.골절평균유합시간위8.5주,무연지유합발생.근거B?stman평분표준,평균분위27.9분,기중우22례(81%)、량4례(15%)、차1례(4%),우량솔위96%.결과현시,재공심랍력라정적기출상보이얼태취빈기고정겸구전통각충내고정방법지우점,동시피면료기불족지처.
@@@@BACKGROUND: There are various internal fixation methods for the clinical treatment of patel ar fractures, but each method has advantages and disadvantages, respectively. The selection of proper internal fixation method wil directly affect the healing time and recovery of knee joint function. OBJECTIVE: To investigate the biomechanical reconstruction effect on patel ar fracture treated with cancel ous bone screw and nickel-titanium-patel ar concentrator internal fixation. METHODS: A retrospective analysis was performed on 27 cases of acute patel ar fracture patients from January 2011 to January 2012 in the Department of Orthopedics, Jinshan Hospital, Fudan University, including 13 cases of transverse fracture, 11 cases of comminuted fracture and three cases of upper or lower pole fracture. Al the 27 patients received cancel ous bone screw and nickel-titanium-patel ar concentrator internal fixation without plaster external fixation, and then the quadriceps active contraction training was performed from the 2nd day after internal fixation, and bed knee flexion and extension exercises were performed at 1 week after internal fixation. The knee joint function was evaluated with B?stman score system. RESULTS AND CONCLUSION: Al the 27 patients were fol owed-up for 4-14 months. Incisions obtained stage Ⅰ healing, and there was no fracture fixation or shedding, wound infection, skin necrosis or other complications. The average healing time was 8.5 weeks without delayed healing. According to clinical grading scale of B?stman score system, the mean score was 27.9, included 27 cases of excel ent (81%), four cases of good (15%), one case of poor (4%), and the excel ent and good rate was 96%. The results suggest that cancel ous bone screw combined with nickel-titanium-patel ar concentrator internal fixation can maintain the advantages of traditional internal fixation method, and can avoid the disadvantages of the traditional internal fixation method.