加压空心螺钉联合钢丝张力带固定治疗髌骨骨折的效果研究

刘德华 唐吉平 林春阳 杨洪杰 项晓伟 周利

[摘要]目的 探討加压空心螺钉联合钢丝张力带固定治疗髌骨骨折的效果。方法 选取2016年8月～2017年8月我院收治的60例髌骨骨折患者作为研究对象，采用随机数字表法将其分为对照组、观察组，每组 30例。对照组采用克氏针张力带进行治疗，观察组采用加压空心螺钉联合钢丝张力带固定进行治疗，比较两组患者的手术时间、术中出血量、下床时间、住院时间、骨折愈合时间、疼痛评分、LKSS评分、膝关节活动度、手术前后Oswestry功能障碍指数以及并发症发生率。结果 观察组患者的手术时间、下床时间、住院时间以及骨折愈合时间均短于对照组（P<0.05），观察组患者的术中出血量少于对照组，差异均有统计学意义（P<0.05）。两组患者术后Oswestry功能障碍指数评分、疼痛评分低于对照组（P<0.05），LKSS评分以及膝关节活动度高于对照组，差异均有统计学意义（P<0.05）。观察组患者的并发症发生率低于对照组，差异有统计学意义（P<0.05）。结论 加压空心螺钉联合钢丝张力带固定治疗髌骨骨折的效果显著，可改善患者的关节功能，降低并发症发生率，有助于提高患者的生活质量，具有较高的临床应用价值。

[关键词]加压空心螺钉；钢丝张力带；内固定；髌骨骨折；应用效果

[中图分类号] R683 [文献标识码] A [文章编号] 1674-4721（2018）5（a）-0101-03

[Abstract]Objective To investigate the effect of cannulated screw fixation combined with tension band fixation in the treatment of patellar fracture.Methods Sixty patients with patellar fracture admitted to our hospital from August 2016 to August 2017 were selected as the research object，and randomly divided into control group and observation group，with 30 cases in each group.The control group was treated with kirschner wire tension band，while the observation group was treated with compression cannulated screw combined with steel wire tension band.The operation time，intraoperative blood loss，bed time，hospitalization time，fracture healing time，pain score，LKSS score，knee joint activity，Oswestry dysfunction index and complication rate were compared between the two groups.Results The operation time，bed time，hospitalization time and fracture healing time in the observation group were shorter than those in the control group，and the differences were statistically significant（P<0.05），and the intraoperative blood loss in the observation group was lower than that in the control group，the difference was statistically significant（P<0.05）.After operation， oswestry dysfunction index score and pain score of the two groups were lower than those of the control group （P<0.05），LkSS score and knee joint activity were higher than those of the control group，the differences were statistically significant （P<0.05）.The incidence of complications in the observation group was lower than that in the control group （P<0.05）.Conclusion The treatment of patellar fracture with cannulated screw fixation and wire tension band is effective in improving the joint function，reducing the incidence of complications and improving the quality of life of patients with high clinical value.

[Key words]Compression hollow screw；Steel wire tension band；Internal fixation；Patellar fracture；Application effect

髌骨骨折是骨科常见的疾病类型，发病率较高，主要是直接暴力或者间接暴力所导致，骨折后一般会出现局部肿胀、淤血、疼痛以及水疱等症状，导致其膝关节自主伸直障碍，可通过髌骨正侧位X线确诊，传统治疗极易影响到患者伸屈膝功能，严重时甚至可导致创伤性关节炎以及关节僵直等并发症，治疗应该坚持早期解剖复位以及早期功能锻炼的原则[1]。本次研究主要探讨加压空心螺钉联合钢丝张力带固定治疗髌骨骨折的效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2016年8月～2017年8月我院收治的60例髌骨骨折患者作为研究对象，采用随机数字表法将其分为对照组、观察组，每组 30例。……