摘要
目的对比髌骨全切术(complete patellectomy,CP)和髌骨部分切除术(partial patellectomy,PP)治疗髌骨粉碎性骨折的远期疗效。方法回顾性分析1980至2003年收治的髌骨粉碎性骨折患者41例,采用PP治疗21例,采用CP治疗20例。末次随访时进行相关膝关节评分并摄患膝X线片,评估患者患肢膝关节功能和影像学情况。结果41例患者随访时间14.2~35.9年,末次随访时PP组患者髌骨上缘10 cm、20 cm处大腿周径分别为(42.95±3.58)cm和(58.14±2.39)cm,CP组患者髌骨上缘10 cm、20 cm处大腿周径分别为(42.95±3.18)cm和(59.05±3.33)cm,差异均无统计学意义(P>0.05)。pp组患者AKS评分为(159.76±27.27)分,CP组为(157.00±25.20)分,差异无统计学意义(t=0.881,P=0.384)。PP组患者Bostman评分为(24.38±2.85)分,CP组为(24.35±2.30)分,2组差异无统计学意义(t=0.038,P=0.970)。PP组患者Lysholm评分为(70.10±13.37)分,CP组为(66.75±14.66)分,2组差异无统计学意义(t=0.764,P=0.449)。PP组患者VAS评分为(2.29±1.68)分,CP组为(2.25±1.62)分,2组差异无统计学意义(t=0.069,P=0.945)。双膝骨关节炎按照K-L分级标准,PP组重度关节炎5例,轻度16例;CP组重度关节炎7例,轻度13例,差异无统计学意义(P=0.747)。结论PP和CP两种术式对髌骨粉碎性骨折的远期疗效不存在显著差异;两种方法治疗髌骨粉碎性骨折,患者远期术后功能评分较低。
Objective To investigate and compare the long term effects between the complete patellectomy(CP)and the partial patellectomy(PP)in treatment of comminuted patellar fractures.Methods A retrospective analysis was performed in 41 patients with comminuted patellar fracture who were admitted and treated from 1980 to 2003,of whom,20 patients were treated by CP,and 21 patients were treated PP.At the last follow-up,the knee joint function in the affected knee and the iconography condition of the patients were evaluated according to knee joint scores and X ray examination results.Results The mean follow upt time of 41 patients was 14.2~35.9 years.At the last follow up,the circumference of the thigh at 10cm and 20cm of the patella upper margin in PP group were(42.95±3.58)cm and(58.14±2.39)cm,moreover the circumferences of the thigh at 10cm and 20cm of the patella upper margin in CP group were(42.95±3.18)cm and(59.05±3.33)cm,respectively,there were no significant differences in the circumferences of the thigh at 10cm and 20cm of the patella upper margin between PP group and CP group(P>0.05).Moreover there were no significant differences in the AKS scores between PP group and CP group(P>0.05).The Bostman scores in PP group were(24.38±2.85)points,which in CP group were(24.35±2.30)points,there were no significant differences between the two groups(P>0.05).The Lysholm scores in PP group were(70.10±13.37)points,which in CP group were(66.75±14.66)points,there were no significant differences between the two groups(P>0.05).There were no significant differences in VAS scores between PP group and CP group(P>0.05).According to the KL grading standard,there were 5 cases of severe arthritis and 16 cases of mild osteoarthritis in PP group,and there were 7 cases of severe arthritis and 13 cases of mild arthritis in CP group,there were no significant differences between the two groups(P>0.05).Conclusion There are no significant differences in long term curative effects between complete patellectomy and partial patellectomy in treatment of comminuted patella fractures.Howeverthe long term postoperative function scores in bothmethods are lower in treatment of comminuted patellarfracture.
作者
李旭
李石伦
李升
李智勇
刘建宁
王伟
郭跻超
徐国辉
齐向北
LI Xu;LI Shilun;LI Sheng(Department of Osteology,Xiangjiangyuan Branch of The Third Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China;不详)
出处
《河北医药》
CAS
2020年第12期1809-1812,共4页
Hebei Medical Journal
基金
河北省卫生和计划生育委员会青年科技课题(编号:20190651)。
关键词
髌骨骨折
髌骨部分切除术
髌骨全切术
治疗结果
patellar fracture
partial patellectomy
complete patellectomy
treatment outcome
