关节镜辅助微创治疗髌骨骨折疗效分析

目的对比关节镜辅助微创治疗与传统切开治疗髌骨简单骨折的初期疗效。方法回顾性分析2017年6月—2017年12月在深圳市人民医院骨关节科手术治疗的髌骨骨折患者24例,男性13例,女性11例;平均年龄(38.0±12.9)岁,均为简单横形骨折。按手术方法分为传统切开组12例,关节镜微创组12例。记录两组患者手术时间、骨折愈合时间、术后膝关节HSS评分及并发症发生率,分析两组患者治疗效果。结果患者均获得门诊随访,随访时间(12.4±2.2)个月。关节镜辅助微创组患者手术时间(49.6±6.2)min显著少于传统切开组(57.9±7.2)min(P=0.006)。两组患者均获得骨性愈合,愈合时间比较差异无统计学意义(11.6±1.3)周vs.(12.3±1.2)周,P=0.210],关节镜辅助微创组患者术后HSS评分优于传统切开组(91.6±3.8 vs.86.3±4.8,P=0.007),两组患者均未出现骨不连、感染和断钉情况。结论相较于传统切开,关节镜辅助微创治疗髌骨骨折具有创伤小、复位质量可靠、术后功能恢复好等优点,且不影响骨折愈合,值得临床推广。

Curative effect of arthroscopy-assisted reduction in patella fracture

Objective To compare initial outcomes of arthroscopy-assisted management and open reduction in patients with patella fracture.Methods From Jun.2017 to Dec.2017,twenty-four patella fracture patients were treated in our hospital.There were 13 males and 11 females,with an average age of(38.0±12.9)years.Patients were randomized into open reduction group(n=12)and arthroscopy-assisted reduction group(n=12).Data on operation time,fracture healing time,postoperative HSS scores and complication rates were collected and analyzed.Results Patients were followed up for an average of(12.4±2.2)months.The operation time of arthroscopy-assisted reduction group was(49.6±6.2)minutes,which was shorter than that of the open reduction group(57.9±7.2)minutes,P=0.006].No significant difference was observed in fracture healing time(11.6±1.3)weeks vs.(12.3±1.2)weeks,P=0.210].Postoperative HSS scores of the arthroscopy-assisted reduction group was(91.6±3.8)points,which was higher than that of the open reduction group of(86.3±4.8)points(P=0.007).Bone nonunion,infection or failure fixation was not found in either groups.Conclusion Compared with open reduction,arthroscopy-assisted reduction in treating patella fracture has advantages of minimal invasion,reliable fixation,good postoperative function after surgery and satisfactory fracture healing.