目的 探讨单根钛缆环扎结合“8”字张力带治疗髌骨骨折的临床疗效.方法 2012年6月-2014年11月,收治46例髌骨骨折患者.男30例,女16例;年龄20～86岁,平均54岁.骨折原因:摔伤27例,交通事故伤16例,击打伤3例.闭合性损伤41例,开放性损伤5例.左侧24例,右侧22例.骨折AO分型:34-A型3例,34-B型1例,34-C1型7例,34-C2型13例,34-C3型22例.受伤至手术时间为1～ 12d,平均3.7 d.采用单根钛缆环扎加“8”字张力带内固定,在髌骨表面形成几何学“球冠”形状的张力带结构.结果 术后患者切口均Ⅰ期愈合.患者均获随访,随访时间6～ 24个月,平均20.6个月.术后1例出现软组织刺激,2例出现1枚克氏针移位、钛缆部分松动.术后3个月复查X线示骨折均已愈合,期间无钛缆断裂发生;38例术后12个月时取出内固定物.术后12个月,按B(o)stman髌骨骨折疗效评分标准评价为24 ～ 30分,平均28.34分;优42例、良4例,优良率100％.结论 单根钛缆环扎结合“8”字张力带治疗髌骨骨折具有固定牢固、并发症少的优点,术后允许早期进行膝关节功能锻炼,临床疗效满意.“,”Objective To estimate the outcome of cerclage followed by a figure-of-eight tension band with a single titanium wire for the treatment of patellar fracture.Methods A retrospective analysis was made on the clinical data of 46 patients with patellar fractures treated between June 2012 and November 2014.There were 30 males and 16 females,aged 20-86 years (mean,54 years).The fracture causes included falling in 27 cases,traffic accident in 16 cases,and knock in 3 cases.There were 41 cases of closed fractures and 5 cases of open fracture.The injury located at the left side in 24 cases and the right side in 22 cases.According to AO classification,fracture was rated as type 34-A in 3 cases,as type 34-B in 1 case,as type 34-C1 in 7 cases,as type 34-C2 in 13 cases,and as type 34-C3 in 22 cases.The time between injury and operation ranged 1-12 days (mean,3.7 days).During operations,a single titanium wire was used to pass around the patellar,followed a figure-of-eight wrapping,to tight and fix at the tension of 35 kg.Results All incisions healed primarily.The patients were followed up 20.6 months on average (range,6-24 months).Partial wire loosening was found in 2 cases,irritation of skin or soft tissue in 1 case.The X-ray examination showed bony healing at 3 months after operation,without breakage of titanium wire.The internal fixation was removed in 38 cases at 12 months after operation.According to the B(o)stman rating score,the mean score was 28.34 (range,24-30) at 12 months after operation;the results were excellent in 42 cases and good in 4 cases,with an excellent and good rate of 100％.Conclusion For patellar fracture,cerclage followed by a figure-of-eight tension band with a single titanium wire is able to achieve an effective stability and to allow early motion for patient with less complication.