| [Objective]The Objective is compared with three different treatment for patella fracture, which is wire cerclage, AO tension band fixation, nickel-titanium within grasp patellar.[Information and methods]1,information93 cases are collected all together. 31 cases of patellar fracture patients were using wire cerclage surgical treatment for the A group. 43 cases of patients were using AO tension band fixation surgical treatment for the B group. 19 cases of patients patients were using nickel-titanium withiin grasp patellar surgical treatemnt for the C group2,treatment2.1 Surgical treatmentIn continuous epidural anesthesia did surgical treatment, 31 cases of patellar fracture patients were using wire cerclage surgical treatment. 43 cases of patients were using AO tension band fixation surgical treatment, 19 cases of patients patients were using nickel-titanium withiin grasp patellar surgical treatment.2.2 Chinese medicine treatmentAfter the surgery within two weeks then take Liuwei bone soup. The prescription is: angelica 12g,achyranthesl2g,drynaria 12g,dipsacus 12g,natural copper 12g,licorice 6g. Adding water flooding over the chinese medicine, boiled and extracted the soup. Daily uses a traditional Chinese medicine and twice a day.2.2 Chinese medicine fumigationIt is not appropriate to give Chinesemedicine fumigation in 3 weeks after surgery, in order to prevent the infection. Three weeks tater, that is to say, sutures was removed after a week. X-ray confirmed that the fracture without displacement and internal fixation without loosening. Considering the condition we could use Traumatology Steaming soup for Fumigation treatment. The prescription is: shenjin grass 12g, pittosporum Paper 12g, frankincense 9g,myrrh 9g,Safflower 10g,Wujiapi 12g. These drugs will be placed in the basin, adding water flooding over Chinese medicine, soak 10 minutes after the fire languishing in 30 minutes. Place the knees on the top of the basin, heat 15-20 minutes. Waiting until liquid medicine temperatures were moderate, then put knees in the soup. Washing and dring knees in order to avoid feeling cold. Immediately let knees flexion and extension. Patients should use soup three times a day. Each medicine could use two days, and 6 days is a course of treatment.2.4 CPM functional exerciseAfter the surgery within 4-5 weeks, using X-ray checks whether internal fixation were firmly implant, we can see whether there are the obvious growht of bones. According to the actual situation, we can use CPM for the functional training.Methods: physical activities started from 30 degrees. Increase 10 degrees each day. Gradually increased to maximum angle. CPM devices should be used daily for at least four hours. Every weekly reviewed X-rays to observr the location of the bone fracture.3,Clinical EvaluationThe patients were followed up. The period is 6-8 months. After surgery three months and six months ,in accordance with the standards Bristol[1] score right get the results of the knee function. Using statistical methods to analyze and compare the results.[Results]After 3 months and 6 months, using wire cerclage group of knee function were assessed fine for 48.39% and 64.52%; AO tension band fixation group knee function were assessed fine for 76.74% and 88.37%; nickel-titanium patellar talon fixation Group knee function were assessed fine for 84.21% and 89.47%. Statistical analysis: Three months later the wire cerclage group knee function score functional evaluation excellent rate were less than the other two groups (P＜0.05), It's has a significant difference. 6 months later wire cerclage group knee function assessment rate is still less than excellent other two groups (P＞0.05), It's has a significant difference. AO tension band fixation group and nickel titanium grasp patellar fixation devices in the group after 3 months and 6 months of knee function score were fine. There was no significant difference (P＞0.05). But the statistical data showed that after 3 months and 6 months, the use of nickel-titanium patellar talon fixation for the treatment of patients excellent rate were less than AO tension band wire fixation for the treatment of the patients.[Conclusion]AO tension band fixation and nickel-titanium patellar talon fixation for the treatment of patellar fracture are more better, and have less complications, There are good method for the patella fracture. |
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