全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
华西医学  2012 

空心拉力螺钉联合钢丝张力带治疗髌骨骨折

DOI: CNKI:51-1356/R.20120214.1530.039, PP. 230-233

Keywords: 髌骨骨折,螺钉,张力带,内固定

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的 探讨空心拉力螺钉联合钢丝张力带治疗髌骨骨折的临床疗效。方法 2005年6月-2010年9月采用空心拉力螺钉联合钢丝张力带治疗髌骨骨折38例,男29例,女9例;年龄32~69岁,平均42.2岁。其中髌骨中份横行骨折18例,斜行骨折15例,髌骨纵行骨折3例,髌骨下极骨折2例。骨折块移位0.6~3.2cm,平均1.7cm。受伤至手术时间1~7d,平均2.1d。末次随访时评估双侧膝关节主观感受、视觉模拟评分(VAS)、患侧膝关节活动度(ROM)、Lysholm评分及影像学变化。结果 患者随访13~54个月,平均19.5个月。康复期内未出现皮肤刺痛、滑囊炎、切口延期愈合或不愈合等临床并发症。末次随访时疼痛VAS评分(1.5±0.9)分,患侧膝ROM为健侧的85.2%。术后2.1~3.2个月,平均2.8个月达到临床骨性愈合。患侧Lysholm评分优27例、良8例、可1例、差2例,优良率92.1%;健侧膝关节Lysholm评分优35例、良1例、可0例、差2例,两侧比较差异无统计学意义(P>0.05)。结论 空心拉力螺钉联合钢丝张力带治疗髌骨骨折可获得较好临床疗效,且术后循序渐进的康复锻炼是膝关节功能得到最大恢复的关键。

References

[1]  [ 6 ] Kumar G, Mereddy PK, Hakkalamani S, et al. Implant removal following surgical stabilization of patella fracture[J]. Orthopedics, 2010, 33(5): DOI: 10.3928/01477447-20100329-14.
[2]  [ 7 ] 李阳, 欧阳跃平, 苟三怀, 等. 三种不同内固定植入物治疗髌骨粉碎性骨折的效果比较[J]. 中国组织工程研究与临床康复, 2008, 12 (4): 760-764.
[3]  [ 8 ] Carpenter JE, Kasman RA, Patel N, et al. Biomechanical evaluation of current patella fracture fixation techniques[J]. J Orthop Trauma, 1997, 11(5): 351-356.
[4]  [ 9 ] Berg EE. Open reduction internal fixation of displaced transverse patella fractures with figure-eight wiring through parallel cannulated compression screws[J]. J Orthop Trauma, 1997, 11(8): 573-576.
[5]  许超, 史晓林, 何滨, 等. 空心加压螺钉张力带治疗髌骨横行骨折[J]. 中国中医骨伤科杂志, 2008, 16 (9): 52-53.
[6]  Reilly DT, Martens M. Experimental analysis of the quadriceps muscle force and patello-femoral joint reaction force for various activities[J]. Acta Orthop Scand, 1972, 43(2): 126-137.
[7]  Ozgüven HN, Berme N. An experimental and analytical study of impact forces during human jumping[J]. J Biomech, 1988, 21(12): 1061-1066.
[8]  陈军号, 许楚才, 陶凯. 空心拉力螺钉钢丝张力带法治疗髌骨骨折[J]. 创伤外科杂志, 2010, 12 (1): 40.
[9]  王健. 空心拉力钉可吸收缝线张力带法治疗髌骨骨折[J]. 临床骨科杂志, 2008, 11(1): 93.
[10]  张健, 安洪, 蒋电明. 髌骨骨折内固定的生物力学研究[J]. 现代医药卫生, 2001, 17(6): 416.
[11]  陈执平, 张俐, 张安祯. 不同屈膝角度下髌骨应力的生物力学研究[J]. 中国骨伤, 1997, 10(1): 12-14.
[12]  [ 1 ] Hohl M. Fracture of the patella[M]. Philadelphia: JB Lippincott, 1975: 1148-1177.
[13]  [ 2 ] Makino A, Aponte-Tinao L, Muscolo DL, et al. Arthroscopic assisted surgical technique for treating patella fractures[J]. Arthroscopy, 2002, 18(6): 671-675.
[14]  [ 3 ] Tandogan RN, Demirors H, Tuncay CI, et al. Arthroscopic-assisted percutaneous screw fixation of select patellar fractures[J]. Arthroscopy, 2002, 18(2): 156-162.
[15]  [ 4 ] 王鹏建, 李超, 张超, 等. 髌骨骨折的分型及其临床应用[J]. 中国骨与关节损伤杂志, 2007, 22 (8): 656-658.
[16]  [ 5 ] Levack B, Flannagan JP, Hobbs S. Results of surgical treatment of patellar fractures[J]. J Bone Joint Surg(Br), 1985, 67(3): 416-419.
[17]  El-Sayed AM, Ragab RK. Arthroscopic-assisted reduction and stabilization of transverse fractures of the patella[J]. Knee, 2009, 16(1): 54-57.
[18]  Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale[J]. Am J Sports Med, 1982, 10(3): 150-154.
[19]  Dahlkvist NJ, Mayo P, Seedhom BB.Forces during squatting and rising from a deep squat[J]. Eng Med, 1982, 11(2): 67-76.
[20]  Flynn TW, Soutas-Little RW. Patellofemoral joint compressive forces in forward and backward running[J]. J Orthop Sports Phys Ther, 1995, 21(5): 277-282.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133