摘要
背景:张力带系统目前被广泛用于治疗髌骨骨折,然而对于老年患者,由于骨质疏松及骨折粉碎,采用传统张力带固定对髌骨的稳定性较弱,易出现复位丢失、骨折移位等问题。目的:探讨双重张力带治疗老年骨质疏松性髌骨骨折的可行性。方法:纳入2016年1月至2018年5月大连医科大学附属第二医院创伤骨科收治的15例老年骨质疏松性髌骨新鲜骨折患者,其中男6例,女9例,年龄60-74岁,均接受双重张力带内固定治疗,术后不固定。记录骨折愈合时间、并发症发生情况,随访观察患者膝关节活动范围及Bostman髌骨骨折临床疗效评分。研究得到大连医科大学附属第二医院伦理委员会批准。结果与结论:①15例髌骨骨折均愈合,愈合时间2.0-3.0个月;②随访12-18个月,15例患者无伤口感染,无膝关节僵硬及疼痛不适,无骨折再移位,无内固定物松动及脱出;③末次随访时,15例患者膝关节活动度为(127.5±5.8)°,屈曲活动度较健侧减少(8.7±6.5)°;Bostman髌骨骨折功能评分优13例,良2例,优良率为100%;④结果表明,双重张力带固定治疗老年骨质疏松性髌骨骨折能满足患者术后即刻开始功能康复的要求,骨折固定稳定,膝关节功能恢复满意。
BACKGROUND: At present, tension band system is widely used in the treatment of patellar fracture. However, for elderly patients due to osteoporosis and fracture comminution, the stability of patella with traditional tension band fixation is weak, and it is easy to have some problems, such as loss of fracture reduction, and fracture displacement. OBJECTIVE: To explore the feasibility of double tension band in the treatment of osteoporotic patella fractures in the elderly. METHODS: Fifteen elderly patients with fresh osteoporotic patellar fracture treated in the Department ofOrthopedic Trauma of the Second Affiliated Hospital of Dalian Medical University from January 2016 to May 2018, including 6 males and 9 females, aged 60-74, were treated with double tension band internal fixation and were not fixed after operation. The time of fracture healing, the occurrence of complications, the range of motion of knee joint and the clinical curative effect score of Bostman patellar fracture were recorded. The study was approved by the Ethics Committee of the Second Affiliated Hospital of Dalian Medical University. RESULTS AND CONCLUSION:(1) All 15 cases of patellar fracture healed, and the healing time was 2.0-3.0 months.(2) During the follow-up of 12-18 months, all 15 patients had no wound infection, knee joint stiffness, pain and discomfort, fracture re-displacement, loosening and prolapse of internal fixator.(3) At the last follow-up, the range of motion of the knee joint of 15 patients was(127.5±5.8)°, and the range of flexion was reduced by(8.7±6.5)° compared with the healthy side. The functional score of Bostman patellar fracture was excellent in 13 cases and good in 2 cases, with an excellent and good rate of 100%.(4) The results show that the treatment of senile osteoporotic patellar fracture with double tension band fixation can meet the requirements of functional rehabilitation immediately after operation;the fracture fixation is stable and the functional recovery of knee joint is satisfactory.
作者
李延强
潘德悦
南丰
韩鑫
Li Yanqiang;Pan Deyue;Nan Feng;Han Xin(the Second Affiliated Hospital of Dalian Medical University,Dalian 116023,Liaoning Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第33期5338-5342,共5页
Chinese Journal of Tissue Engineering Research
关键词
骨
内固定
张力带
髌骨
骨折
骨质疏松
骨折愈合
bone
internal fixation
tension band
patella
fracture
osteoporosis
fracture healing
