ABSTRACT
Objective To investigate biomechanical properties of the patella tension plating system in order to provide a theoretical basis for its clinical application. Methods Thirty-six models of artificial patella were randomly divided into 3 groups ( n=12 ) . After transverse patellar fractures were created in the models, the 3 groups were subjected to fixation respectively with Kirschner wire tension band ( tension band group ) , patellar concentrator ( concentrator group ) and patellar tension plate ( tension plate group ) . Next, 6 specimens from each group were placed on a mechanical testing machine to measure the fracture displacements after 100 cycles of simulated knee flexion and extension movements. Tensile strength tests were performed on the remaining 6 specimens in each group to measure the maximum load at fixation failure. Results The fracture displacement in the tension plate group ( 0. 40 ± 0. 26 mm ) was significantly smaller than those in the tension band group ( 2. 58 ± 0. 72 mm ) and in the concentrator group ( 1. 25 ± 0. 74 mm ) ( P < 0. 05 );the maximum load at fixation failure in the tension plate group ( 1 , 709 ± 206 N ) was significantly greater than those in the tension band group ( 581 ± 122 N ) and in the concentrator group ( 1, 003 ± 211 N ) ( P <0. 05 ) . Conclusion As a new treatment for patellar fractures, the patellar tension plating system can perform better in biomechanical properties than Kirschner wire tension band and patellar concentrator.
ABSTRACT
BACKGROUND: There are various treatment methods for femoral neck fracture in the elderly, and they have advantages and disadvantages, especially for the elderly type of stable femoral neck fractures Garden type II of treatment options. OBJECTIVE: To summarize the current main clinical methods of senile femoral neck fractures of Garden type II, compare the advantages and disadvantages of internal fixation and joint replacement, and provide the best treatment for orthopedic surgeons. METHODS: We retrieved PubMed database. Key words were elderly femoral neck fracture, Garden type II, selection strategy and progress. Combining with the clinical cases encountered in the comparative analysis, the relevant discussion was analyzed. RESULTS AND CONCLUSION: Although the risk of surgery and the pain of non-surgical patients in early stage, the effects are not ideal. Internal fixation of Garden type II femoral neck fracture and joint replacement in elderly patients is controversial. For the elderly and Garden type II femoral neck fractures, the rate of revision after cannulated screw fixation was significantly higher than that of hip replacement. Both cement-type and biological-type implant prosthesis can improve hip function largely, and reduce non-surgical complications, and finally get a satisfactory clinical effect. The clinician should make the best treatment plan according to the patient’s age, bone condition, fracture type and physical condition.