摘要
[目的]介绍聚酯缝线结合Nice结内固定治疗横行髌骨骨折的手术技术和初步临床效果。[方法]2019年6月—2022年3月对20例横行髌骨骨折患者采用聚酯缝线联合Nice结完成复位内固定治疗。采用膝前正中切口,复位骨折后沿髌骨纵轴建立4条均匀分布的骨隧道。使用5#不可吸收聚酯缝线经邻近关节面的2条骨隧道穿线后于髌骨表面行“8”字捆扎,再使用5#不可吸收聚酯缝线经另外2条骨隧道行环形捆扎,均以Nice结固定。[结果]全部患者均顺利完成手术,无严重并发症,手术时间为50~90 min。患者均获随访,随访时间12~18个月。末次随访时,B?stman髌骨骨折功能评分平均(28.3±1.6)分,膝关节最大活动度为(132.3±4.2)°,依据Bostman髌骨骨折功能评分标准,所有患者患膝功能均达优良级,所有骨折均获愈合。[结论]聚酯缝线联合Nice结固定治疗横行髌骨骨折具有固定牢靠,无需再次手术取出内固定的优势,短期临床疗效满意。
[Objective]To introduce the surgical technique and preliminary clinical results of polyester sutures with Nice knots for fixation of transverse patella fractures.[Methods]A total of 20 patients underwent non-absorbable polyester sutures with Nice knots for fixation of transverse patellar fractures.After anterior midline incision of the knee was made to expose the patella,the fractures were debrided and reduced,and 4 evenly distributed bone tunnels were established along the longitudinal axis of the patella.The tension band of the suture in figure of 8 was performed on the surface of the patella after the 5#non-absorbable polyester sutures were introduced through the deeper 2 bone tunnels near articular surface.Finally,a circular band was performed with 5#non-absorbable polyester sutures through the other superficial2 bone tunnels.All the suture bundles were tensioned and fastened with Nice knots to fix the fracture.[Results]All the patients had operation performed successfully without serious complications,while with operation time of 50~90 min.At the latest follow up lasted for 12 to 18months,all of them achieved fracture healing with B?stman patellar fracture function score of(28.3±1.6),and the knee range of motion of(132.3±4.2)°.According to the Bostman patellar fracture function score,all patients were graded as excellent in term of knee function.[Conclusion]Polyester sutures with Nice knots for fixation of transverse patellar fracture has the advantages of reliable fixation,less complications,and no need for reoperation to remove the internal fixation,does achieve satisfactory clinical consequences in short-term.
作者
张增辉
韩体超
郭玉坤
周洋洋
张俊
张俊宇
王小龙
尹宗生
ZHANG Zeng-hui;HAN Ti-chao;GUO Yu-kun;ZHOU Yang-yang;ZHANG Jun;ZHANG Jun-yu;WANG Xiao-long;YIN Zong-sheng(Department of Joint Surgery and Traumatic Orthopedics,People's Hospital of Linquan County,Linquan 236400,China;The First Affiliated Hospital,Anhui Medical University,Hefei 230022,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2024年第3期263-266,共4页
Orthopedic Journal of China
基金
阜阳市卫健委科研课题面上项目(编号:FY2021-180)。
关键词
髌骨骨折
聚酯缝线
Nice结
内固定
patellar fracture
polyester suture
Nice knot
internal fixation
作者简介
张增辉,主治医师,研究方向:关节创伤,(电话)15655832189,(电子信箱)zzh36903@163.com;通信作者:韩体超,(电话)13966588860,(电子信箱)htc1580305@163.com。
