医用钛缆在髌骨粉碎性骨折治疗中的应用_临床医学论文.docVIP

医用钛缆在髌骨粉碎性骨折治疗中的应用_临床医学论文 医用钛缆在髌骨粉碎性骨折治疗中的应用_临床医学论文 作者：叶添文，李阳，欧阳跃平，苟三怀，严望军，刘铁龙，徐盛明，刘岩，陈爱民 【摘要】 　　目的 回顾性研究钛缆环扎固定法治疗髌骨粉碎性骨折的临床效果。[方法]2004年11月～2007年8月收治的髌骨粉碎性骨折57例，根据内固定方式分成3组：钛缆环扎固定组、AO改良张力带固定组、镍钛聚髌器固定组。探讨各组的手术时间、出血量、膝关节术后首次锻炼时间、住院时间、医疗费用、损耗工作日、并发症及远期膝关节功能情况，并进行统计学分析。[结果]57例患者均获得11～48个月的随访，平均22.4个月。钛缆环扎固定组患者术后开始伸屈膝关节锻炼时间最早，平均约5.6 d，但医疗费用较贵，约为0.95万元。应用改良的Bostman髌骨骨折临床疗效评分标准评估远期疗效，钛缆环扎固定组优良率为95.1%，明显高于其余2组。[结论]钛缆系统对髌骨粉碎性骨折固定牢靠，具有膝关节锻练时间早，并发症少等优点，是治疗髌骨粉碎性骨折的一种新的选择方法。 【关键词】 髌骨损伤 粉碎性骨折 骨折内固定 钛缆系统 　　Abstract：[Objective]To study the effects of titanium cable system used as a treatment alternative for comminuted patella fractures.[Method]Fifty-seven cases of comminuted patella fractures were treated from November 2004 to August 2007. The patients were divided into three groups: the group of titanium cables, AO modified tension band and nickel titanium-patella catcher respectively,according to the choice of internal fixation. The operation time, the amount of blood loss, the first knee exercise time after operation, length of hospitalisation,medical expenses, time off for employees, complication and long-term knee function were studied. All the data were analyzed and compared by statistical ways.[Result]The 57 patients were followed up for 11 to 48months (means,22.4 m).Patients who were fixed with titanium cables could start most early extending and flexing the knee(5.6 d after operation),but most expense in medical usages(9500 RMB). The good or excellence rate was 95.1% in patients treated with titanium cables cerclage, which was better than that of the other two groups.[Conclusion]Titanium cables cerclage can cure comminuted patella fractures. The method had advantage of better long-term curative effect and less complication, and so on.Its worthy to be recommended for the therapy of comminuted patella fracture. 　　Key words：patella injury; comminuted fractures; internal fixation; titanium cable system 　　髌骨骨折约占全身骨折发生率的0.5%～1.5%[1]，其中1/3为粉碎性骨折。髌骨粉碎性骨折是一种严重的关节内骨折，治疗具有一定难度，因此，治疗