聚酯缝线Nice结固定横行髌骨骨折△

Polyester sutures with Nice knots for fixation of transverse patella fracture

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 B?stman 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。

Abstract:

[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 superficial 2 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 18 months, 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 B?stman 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.