中国组织工程研究

中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (6): 934-937.doi: 10.12307/2022.180

• 骨科植入物 orthopedic implant • 上一篇    下一篇

聚髌爪固定与袢钢板结合聚髌爪固定治疗髌骨下极粉碎性骨折的稳定性对比

段  超1，尚晓强1，段祥林1，杨  平1，陶圣祥2   

  1. 1武汉市红十字会医院骨科，湖北省武汉市   430015；2武汉大学中南医院骨科，湖北省武汉市   430071
  • 收稿日期:2021-04-22 修回日期:2021-04-23 接受日期:2021-05-26 出版日期:2022-02-28 发布日期:2021-12-08
  • 通讯作者: 段祥林，主任医师，武汉市红十字会医院骨科，湖北省武汉市 430015
  • 作者简介:段超，男，1980年生，湖北省黄冈市人，汉族，2005年武汉大学毕业，主治医师，主要从事骨科临床研究。
  • 基金资助:
    武汉市卫计委2017年医学科研项目面上项目(WX17A11)，项目负责人：段祥林

Stability of patellar claw versus loop plate combined with patellar claw for the treatment of comminuted fractures of the lower pole of the patella 

Duan Chao1, Shang Xiaoqiang1, Duan Xianglin1, Yang Ping1, Tao Shengxiang2   

  1. 1Department of Orthopedics, Wuhan Red Cross Hospital, Wuhan 430015, Hubei Province, China; 2Department of Orthopedics, Zhongnan Hospital, Wuhan University, Wuhan 430071, Wubei Province, China
  • Received:2021-04-22 Revised:2021-04-23 Accepted:2021-05-26 Online:2022-02-28 Published:2021-12-08
  • Contact: Duan Xianglin, Chief physician, Department of Orthopedics, Wuhan Red Cross Hospital, Wuhan 430015, Hubei Province, China
  • About author:Duan Chao, Attending physician, Department of Orthopedics, Wuhan Red Cross Hospital, Wuhan 430015, Hubei Province, China
  • Supported by:
    the General Project of Wuhan Municipal Health and Family Planning Commission Medical Research Project in 2017, No. WX17A11 (to DXL)

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摘要：

文题释义：
髌骨下极骨折：是指髌骨下端无关节软骨覆盖的部分发生的骨折，髌骨下极骨折是临床中并不少见的髌骨骨折类型，严格来说是归属于关节外骨折，在整个髌骨骨折中占5%左右的比例，在临床中见到的髌骨下极骨折，绝大多数为粉碎性骨折。在膝关节伸膝力传导过程中，髌骨下极的作用非常重要。

背景：髌骨下极粉碎性骨折缝合髌韧带后再行聚髌器固定也能增加下极的把持力，部分学者报道该内固定方式固定牢固，无松动，可早期行康复功能锻炼，但有刺激软组织及损伤软骨的风险。
目的：通过在尸体上进行生物力学实验来研究袢钢板结合聚髌爪技术治疗髌骨下极粉碎性骨折的力学稳定性。
方法：选取6具新鲜成人尸体标本，总共使用12个膝关节，采用微型摆锯将尸体标本髌骨制成髌骨下极粉碎性骨折模型，选取每具标本一侧髌骨使用袢钢板结合聚髌爪内固定的方式建成实验力学模型，另一侧行单纯聚髌爪固定建成实验力学模型，对髌韧带进行加载测试，经过加载负荷后分别记录能够使上述骨折模型的骨折端发生大体可见的分离1 mm和2 mm时的最大张力，并进行统计学分析。 实验研究经武汉市红十字会医院伦理委员会全体会议讨论通过，伦理委员会审查编号：20161201。
结果与结论：①聚髌爪结合袢钢板固定组骨折端分离1 mm及2 mm的最大张力分别为(254.35±9.14) N和(274.23±15.06) N；聚髌爪固定组骨折端分离1 mm及2 mm的最大张力分别为(106.00±4.79) N和(120.62±5.73) N；袢钢板结合聚髌爪固定组在最大张力显著高于单纯聚髌爪固定组(P < 0.001)；②结果说明，聚髌爪结合袢钢板治疗髌骨下极粉碎性骨折生物力学稳定，有较强的安全性，对于早期行被动康复锻炼提供了稳定的固定基础。

https://orcid.org/0000-0002-1298-9616 (段超) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 髌骨, 生物力学, 聚髌爪

Abstract: BACKGROUND: After the comminuted fracture of the lower pole of the patella is sutured with the patellar ligament, the patellar concentrator can also increase the holding power of the lower pole. Some scholars report that the internal fixation method is firmly fixed without loosening, and early rehabilitation can be performed, but it is irritating risk of soft tissue and damage to cartilage.  
OBJECTIVE: To study the mechanical stability of loop plate combined with patellar claw technique in the treatment of the comminuted fracture of the inferior patella through the cadaver biomechanical experiment.
METHODS:  Totally six fresh adult cadavers were selected, including 12 knee joints, which were made into the model of comminuted fracture of the lower pole of patella by swing saw. One side of patella was fixed by loop plate combined with poly patella claw to form the experimental mechanical model. The other side was fixed by poly patella claw to form the experimental mechanical model. The loading test was carried out on the patella ligament. The maximum tension of 1 mm and 2 mm of fracture end separation was recorded respectively by loading load, and statistical analysis was performed. The experimental study was approved by the Plenary Meeting of the Ethics Committee of Wuhan Red Cross Hospital (approval No. 20161201).  
RESULTS AND CONCLUSION: (1) The maximum tension of 1 mm and 2 mm was (254.35±9.14) N and (274.23±15.06) N in the loop plate combined with patellar claw fixation group, respectively. The maximum tension of 1 mm and 2 mm was (106.00±4.79) N and (120.62±5.73) N in the patellar claw fixation group, respectively. The maximum tension of the loop plate combined with patellar claw fixation group was significantly higher than that of the patellar claw fixation group (P < 0.001). (2) The findings indicate that the treatment of comminuted fracture of the lower patella with loop plate combined with patellar claw is stable, safe and reliable in biomechanics, and can be used for passive rehabilitation exercise in the early stage.

Key words: patella, biomechanics, poly patellar claw

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