CablePin系统选择性治疗髌骨骨折疗效分析.doc

CablePin系统选择性治疗髌骨骨折疗效分析 　 作者：蔡晓冰，佟大可，纪方　张秋林，唐昊，韩凯伟 【摘要】 [目的]探讨应用CablePin系统内固定治疗髌骨骨折的临床疗效。[方法]2005年10月～2007年5月，利用CablePin系统选择性治疗髌骨骨折35例，均为闭合性髌骨骨折患者，其中横行骨折19例，粉碎性骨折16例，男21例，女14例;年龄21～75岁。切开复位后，垂直骨折线或主要骨折块选择适当长度2根半螺纹拉力螺钉用动力系统攻钻入骨，然后在髌骨远端(或近端)横行钻一骨隧道，用钢缆穿过隧道，在髌骨前方“8”字结扎，用专用器械收紧钢缆，以专用束缚器将钢缆固定，16例粉碎性髌骨骨折，全部于髌骨外侧环扎。[结果]本组35例患者随访12～18个月,平均13.2个月。伤口均Ⅰ期愈合，无感染发生。骨折全部愈合。无退钉、钢缆松脱和皮肤刺激等并发症发生。以Bostman髌骨骨折疗效评分标准进行评分：优32例，良3例，优良率为100%。[结论]CablePin系统对骨折固定牢固可靠，术后并发症发生率低，是治疗髌骨骨折的一种新方法。 【关键词】 髌骨; 骨折内固定术; CablePin系统 　　Abstract：[Objective]To study the effects of CablePin system used as a treatment alternative for patellar fractures.[Method]Thirtyfive cases of patellar fracture were operated with the CablePin system from October 2005 to May 2007.Their diagnosis were 19 transverse close ractures and 16 comminuted of patella.There were 21 males and 14 females.Their ages ranged from 21 to 75 years old.After open reduction，the author used a drill bit vertically through the patella in a superior direction，drilled the threaded portion of the pin across the fracture site，inserted a second Cable Pin through the second hole in a similar manner.A horizontally directed drill hole anterior to the pins was created in the superior pole of the patella.The two cables were crossed in a fighre eight over the an terior surface of the patella.The Crimper Tensioning Handle was， the cable carefully，the handles of the crimper were squeezed until the crimp was fully crimped.[Result]The 35 patients were followed up for 12 to 18 months(mean 13.2 m).Fractures healed in all the cases without such complications as loosening of screw and cable loop,loss of reduction or irritation to soft tissue.Restoration of the knee joint motion was excellent in 32 cases and good in 3 cases according to Bostman score system.[Conclusion]CablePin system as a new option for the treatment of patella fracture，can result in reliable fixation and low rate of complications. 　　Key words：patella; fracture internal fixation; CablePi