标题：Krachow法缝合联合钢丝垂直间断固定对髌骨下极粉碎性骨折患者关节功能及预后的影响

      作者：张大保，毛波，赖金平    佛山市第五人民医院骨科，广东 佛山 528211

      卷次： 2019年30卷7期

      【摘要】 目的 探讨Krachow法缝合联合钢丝垂直间断固定对髌骨下极粉碎性骨折患者关节功能及预后的影响，为临床提供参考依据。方法 选择2015年6月至2018年5月在佛山市第五人民医院骨科治疗的髌骨下极粉碎性骨折患者 50例为研究对象，按照随机数表法将患者分为观察组和对照组，每组 25例。观察组患者采用Krachow法缝合联合钢丝垂直间断固定方式治疗，对照组患者则采用张力带钢丝固定方式治疗，术后随访 6个月比较两组患者的关节功能、骨折愈合时间、膝关节屈伸活动范围与膝关节Bostman评分以及并发症发生情况。结果 观察组患者的治疗优良率为92.0%，明显高于对照组的72.0%，差异有统计学意义(P<0.05)；观察组患者的骨折愈合时间为(8.7±1.1)周，明显短于对照组的(9.9±1.5)周，膝关节屈伸活动范围为(125.6±5.6)°，明显高于对照组的(114.2±4.9)°，膝关节Bostman评分为(27.0±1.1)分，明显高于对照组的(21.34±0.8)分，以上各项指标比较差异均有统计学意义(P<0.05)；观察组患者术后并发症发生率为8.0%，明显低于对照组的32.0%，差异有统计学意义(P<0.05)。结论 Krachow法缝合联合钢丝垂直间断固定对髌骨下极粉碎性骨折患者进行治疗，疗效显著，并发症发生率低，值得在临床推广。
      【关键词】 Krachow法；内固定；髌骨骨折；粉碎性骨折；关节功能；并发症
      【中图分类号】 R683.42 【文献标识码】 A 【文章编号】 1003—6350（2019）07—0856—03

Effect of Krachow suture combined with vertical wire fixation on joint function and prognosis in patients withcomminuted humeral fracture.
ZHANG Da-bao, MAO Bo, LAI Jin-ping. Department of Orthopedics, the 5th People'sHospital of Foshan City, Foshan 528211, Guangdong, CHINA
【Abstract】 Objective To explore the effect of Krachow suture combined with vertical wire fixation on thejoint function and prognosis of patients with comminuted humeral fractures, and provide reference for clinical practice.Methods A total of 50 patients with comminuted humeral fractures treated in the Department of Orthopaedics at the 5thPeople's Hospital of Foshan City from June 2015 to May 2018 were selected as subjects. The patients were randomly di-vided into observation group and control group according to the random number table method, with 25 cases in eachgroup. Patients in the observation group were treated with Krachow suture and vertical wire fixation, and the controlgroup was treated with tension band wire fixation. After 6 months of follow-up, the joint function, fracture healingtime, knee flexion and extension range, knee joint score, and complications were compared between the two groups.Results The excellent and good rate of treatment in the observation group was 92.0%, which was significantly higherthan 72.0% in the control group (P<0.05). In the observation group, the fracture healing time was (8.7 ± 1.1) weeks,which was significantly shorter than (9.9 ± 1.5) weeks in the control group; the knee flexion and extension range was(125.6±5.6)°, which was significantly higher than (114.2±4.9)° in the control group; the knee joint score was (27.0±1.1)points, which was significantly higher than (21.34±0.8) points in the control group; all differences were statistically sig-nificant (P<0.05). The incidence of postoperative complication in the observation group was 8.0%, which was signifi-cantly lower than 32.0% of the control group (P<0.05). Conclusion Krachow suture combined with vertical wire fixa-tion for the treatment of comminuted humeral fractures of the lower tibia has significant curative effect and low compli-cation rate, which is worthy of clinical promotion.
      【Key words】 Krachow method; Internal fixation; Humeral fracture; Comminuted fracture; Joint function; Com-plications