CAJ | 학술논문

目的：比较分析髌骨爪与线缆固定治疗髌骨骨折的临床疗效。方法选取需做髌骨骨折固定术的患者76例，包括32例线性骨折，44例粉碎性骨折，随机均分为髌骨爪固定组和线缆固定组（n=38）。髌骨爪组患者采用髌骨爪固定骨折的髌骨，而线缆固定组采用传统的固定针和线缆固定髌骨。手术后1周让患者进行适度的步行活动，观察2组患者功能性活动的状态，术后5周时，再次为患者拍摄X线片，检查髌骨愈合情况。结果术后1周时比较2组患者功能性活动的情况，髌骨爪组：良好17例，中等18例，差3例；而线缆固定组：良好10例，中等16例，差12例，髌骨爪组显著好于线缆固定组，差异有统计学意义（P<0.05）。术后5周的X线片显示，髌骨爪组有55.26%的患者已有骨愈合，骨折线已模糊，而线缆固定组仅有34.21%的患者存在骨愈合，差异有统计学意义（P<0.05）。结论对髌骨骨折的患者采用髌骨爪固定后，术后患者疼痛减轻，大多数患者早期即可下床借助外力的作用自己进行走步活动，而还有一部分患者甚至不依靠外力的帮助就能进行下肢的活动。5周的X线片也清楚显示了骨折线的变化，与术前的骨折片对比，术后骨折出已有新骨形成。
목적：비교분석빈골조여선람고정치료빈골골절적림상료효。방법선취수주빈골골절고정술적환자76례，포괄32례선성골절，44례분쇄성골절，수궤균분위빈골조고정조화선람고정조（n=38）。빈골조조환자채용빈골조고정골절적빈골，이선람고정조채용전통적고정침화선람고정빈골。수술후1주양환자진행괄도적보행활동，관찰2조환자공능성활동적상태，술후5주시，재차위환자박섭X선편，검사빈골유합정황。결과술후1주시비교2조환자공능성활동적정황，빈골조조：량호17례，중등18례，차3례；이선람고정조：량호10례，중등16례，차12례，빈골조조현저호우선람고정조，차이유통계학의의（P<0.05）。술후5주적X선편현시，빈골조조유55.26%적환자이유골유합，골절선이모호，이선람고정조부유34.21%적환자존재골유합，차이유통계학의의（P<0.05）。결론대빈골골절적환자채용빈골조고정후，술후환자동통감경，대다수환자조기즉가하상차조외력적작용자기진행주보활동，이환유일부분환자심지불의고외력적방조취능진행하지적활동。5주적X선편야청초현시료골절선적변화，여술전적골절편대비，술후골절출이유신골형성。
Objective To analyze and compare the clinical efifcacy of patella concentrator and ifxed cables in the treatment of patella fracture. Methods 76 cases of patella fracture patents needed ifxation operation in orthopaedics of the ifrst afifliated hospital of guangdong pharmaceutical university were randomly divided into patella concentrator group and ifxed cables group(n=38), including 32 cases of ifssured fracture and 44 cases of comminuted fracture patients. The patella concentrator group ifxed the patella by patella concentrator, and ifxed cables group ifxed the patella by traditional needles and ifxed cables. Making the patients walk properly 1 week after surgery, the functional activities status of two groups were observed. 5 weeks after treatment, two groups took X-rays to examine the healing condition of patella.Results After 1 week of treatment, the functional activities status of patella concentrator group was signiifcantly better than ifxed cables group (P<0.05). Five weeks after treatment, the X-ray results showed that 55.26% of the patella of patients in patella concentrator group had healed, the fracture line was unclear, and there were only 34.21% patients in ifxed cables had healed, with statistical signiifcance (P<0.05).Conclusion After adopting patella concentrator in the treatment of patella fracture, the pain of patients has relieved, most of the patients can get out of the bed and walk with other helps by themselves in the early, and some patients can work on their own without help. The X-ray shows the changes of fracture line clearly, and it can tell there are newly formed bones after sugery by comparing with the imaging before.