The Evaluation of Surgical Treatment for Patellar Fracture

臏骨骨折手術治療後的評估

王叔昂(Shu-Ang Wang) ； 方宗義(Chung-Zia Fang) ； 羅惠熙(Wai-Hee Lo) ； 楊大中(Dah-Jung Yang) ； 陳世良(Shyh-Liang Chen)

《Journal of Orthopaedic Surgery Taiwan》 4卷1期 (1987/03) Pp. 15-21

摘要

民國六十九年一月，迄七十三年十二月間，本院計有七十五個臏骨骨折病患，分別接受(一)全臏骨切除術(二)部份臏骨切除術(三)臏骨內固定術(四)張力鋼圈固定術等手術治療。紿囘溯追蹤1.1年至4年( 平均3.4年 )，檢查結果以主觀及客觀的方法、評估(1)病人主訴的疼痛感，(2)膝關節活動的範圍，(3)病人對手術結果的滿意程度，(4)伸肌強度等，結果發現：病人在91)要(3)、(4)項無論接受那一種手術方式，均無統計學上有意義的差異，唯在「膝關節活動的範圍」，接受「全臏骨切除術」的，比較接受「張力鋼圈固定術」的，有顯著優良的結果。
總結臏骨骨折病例，如其情況可以用「張力鋼圈固定術」治療，即達到很好的復位及固定作用，而母需藉助石膏固定者，病人術後可作早期復健，則為一理想的治療方式，但如其唬( 骨折程度 )無法作很好的復位或固定，則「全臏骨切除術」反較有令人滿意的結果。

並列摘要

Seventy five patients with patellar fractures operated on at Taipei Veterans GeneralHospital between January 1980 and December 1984, were followed up retrospectively for 1.1 to 4 years (average 3.4 years). They were treated by (1) Total patellectomy, (2) Partial patellectomy, (3) Osteosynthesis,and (4) Tension band wiring respectively.
We evaluated the results of individual operations subjectively and objectively under the headings of (1) pain, (2) range of motion, (3) subjective assessment, and (4) quadriceps muscle strength.
We discovered that the results of the pain, subjectie assessment, and the quadricps muscle strength tests showed little difference among any of the methods of operation for all patellar fractures. But the tatal patellectomy provided the best result in the range of motion.
We concluded that if anatomical reduction and rigid fixation could be achieved, the tension band wiring technique which could provide early mobilization was preferred. Otherwise total patellectomy gave satisfactory results.

並列關鍵字

osteosynthesis ； tension band wiring ； spring scale ； cybex-II dynamometer