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Objective:To evaluate the clinical efficacy of cannulated screws with sutures in the treatment of patellar transverse fractures.Methods:A retrospective analysis was performed of the data of 70 patients with patellar transverse fracture who had been admitted to Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital from January 2017 to March 2021. According to the construction methods for the tension band, the patients were divided into 3 groups. In group A of 21 cases subjected to fixation with cannulated screws with sutures (Fiber-Tape), there were 8 males and 13 females with a median age of 55.0 (48.0, 65.0) years; in group B of 32 cases subjected to fixation with Kirschner wire tension band, there were 15 males and 17 females with a median age of 52.5 (41.5, 63.0) years; in group C of 17 cases subjected to fixation with Cable-Pin system, there were 5 males and 12 females with a median age of 55.0 (37.0, 65.0) years. The 3 groups were compared in terms of complications, secondary surgery (removal of internal fixation), operation time, intraoperative blood loss and knee function rated by the Lysholm and B?stman scores at the last follow-up.Results:There were no significant differences in the preoperative general data between the 3 groups, showing they were comparable ( P > 0.05). There was no significant difference in the operation time, intraoperative blood transfusion or follow-up time among the 3 groups ( P > 0.05). The incidence of soft tissue irritation [4.8% (1/21)] and the secondary operation rate [4.8% (1/21)] in group A were significantly lower than those in group B [43.8% (14/32) and 37.5% (12/32)] and group C [41.2% (7/17) and 35.3% (6/17)] ( P < 0.05), but there was no statistically significant difference between group B and group C ( P > 0.05). In groups A, B and C, respectively, the Lysholm knee score was 84.0 (69.0, 88.0), 89.0 (71.5, 95.0) and 82.0 (63.0, 90.0), and the B?stman knee score 26.0 (23.0, 28.0), 26.5 (24.0, 27.5) and 26.0 (22.0, 28.0), showing no significant difference ( P > 0.05). There was no significant difference either in the incidence of other complications among the 3 groups ( P > 0.05). Conclusion:In the treatment of patellar transverse fractures, compared with the Kirschner wire tension band and Cable-Pin system, cannulated screws with sutures (Fiber-Tape) may lead to a lower incidence of soft tissue irritation and a lower rate of secondary surgery, but no significant differences in operation time, intraoperative blood loss, other complications or postoperative functional scores.
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This meta-analysis compared the therapeutic effect of cable pin system (CPS) with K-wire tension band (KTB) in the treatment of patella fractures among Chinese Han population.The databases of PubMed,Cochrane library,China National Knowledge Infrastructure (CNKI),Chinese WanFang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population.Literatures were screened according to the inclusion and exclusion criteria.The quality of the studies was assessed,and meta-analysis was performed using the Cochrane Collaboration's REVMAN 5.3 software.A total of 932 patients from 15 studies were included in this meta-analysis (426 fractures treated with CPS and 506 fractures treated with KTB).There were significant differences in duration of hospital stay [mean difference (MD)=-1.07;95％ confidence interval (CI):-1.71 to-0.43],fracture healing time (MD=-l.23;95％ CI:-1.68 to-0.77),flexion degree of knee joint at 6th month after operation (MD=14.82;95％ CI:10.93 to 18.71),incidence of postoperative complication [risk ratio (RR)=0.16;95％ CI:0.09 to 0.27] and excellent-good rate of B(o)stman score (RR=1.09;95％ CI:1.03 to 1.16) between the CPS group and KTB group,while no significant difference was found in operative time between the two groups (MD=-4.52;95％ CI:-11.70 to 2.67).For the treatment of patella tractures among Chinese Han population,limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay,fracture healing time,flexion degree of knee at 6th month after operation,incidence of postoperative complication and excellent-good rate of B(o)stman joint score.Due to the limitation of high quality evidence and sample size,more large-scale randomized controlled trials are needed to validate the findings in the future.
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183 Background More clinical Sdoctors tend to choose minimally invasive treatments for patella fracture. Because patients have lower complications, better function and perfect incision, which makes them early continue working and influences a little on their careers and life. Objective To explore the efficacy of minimally invasive treatment of patella transverse of young people, we choose percutaneous cannulated screw and titanium cable that we design to operate surgery.we observe the surgical incision, hemorrhage and function Methods From February 2009 to June 2012, we applied the minimally invasive technique of percutaneous cannulated screw and titanium cable to treat 30 cases of patella transverse, 16 males and 14 females. Aged 24-45 years, mean 35.4 years.injury mechanism:10 cases in the traffic accident, 6 cases in the fall s injury, 14 cases in the kneeling injury. fracture type:6 cases proximal pole fracture, 11 cases middle pole fracture and 13 cases distal pole fracture. Result All patients healed incision. 30 cases were followed up for mean 18 months. Fracture healed in mean 6.8 weeks. According to Lysholom function score, excellent in 27 cases, good in 2 cases, good rate of 100%. Conclusion Minimally invasive technique of percutaneous cannulated screw and titanium cable to treat the patella transverse fracture is the better choice. It fixes reliable, follow the biomechanical and have low surgical damage. Patients have less complication and get a good clinical efficacy. It is a better choice to treat patella transverse fracture of young fracture.
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[Objective]To study the effects of Cable-Pin system used as a treatment alternative for patellar fractures.[Method]Thirty-five cases of patellar fracture were operated with the Cable-Pin system from October 2005 to May 2007.Their diagnosis were 19 transverse close ractures and 16 comminuted of patella.There were 21 males and 14 females.Their ages ranged from 21 to 75 years old.After open reduction,the author used a drill bit vertically through the patella in a superior direction,drilled the threaded portion of the pin across the fracture site,inserted a second Cable Pin through the second hole in a similar manner.A horizontally directed drill hole anterior to the pins was created in the superior pole of the patella.The two cables were crossed in a fighre eight over the an-terior surface of the patella.The Crimper Tensioning Handle was,the cable carefully,the handles of the crimper were squeezed until the crimp was fully crimped.[Result]The 35 patients were followed up for 12 to 18 months(mean 13.2 m).Fractures healed in all the cases without such complications as loosening of screw and cable loop,loss of reduction or irritation to soft tissue.Restoration of the knee joint motion was excellent in 32 cases and good in 3 cases according to Bostman score system.[Conclusion]Cable-Pin system as a new option for the treatment of patella fracture,can result in reliable fixation and low rate of complications.
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Objective To explore the curative effects of open reduction and internal fixation with Cable Pin or tension band wire for patellar transverse fractures.Methods Totally 28 cases and another 30 cases were enrolled in the Cable Pin group(8 months for average follow-up time) and the tension band wire group respectively(16 months for average follow-up time).The operative time,the average clinical healing time and the average range of the knee flexion between the 2 groups were compared.Results Obvious superiority was observed in the Cable Pin group over the tension band wire group concerning the average clinical healing time and the average range of the knee flexion 6 months postoperatively (P
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Objective:To investigate the effect of cable pin internalfixation for treatment of patellar fracture.Methods:12 cases with patellar fracture were treated by cable pin internalfixation.Results:The post-operative function in 12 cases was evaluated according to Lu Yu-pu score,follow-up averaged 10 months,and the results were :excellent in 9 cases(75%);good in 2 cases(16.7%);fair in 1 cases(8.3%);poor in 0 case.The excellent rate was 91.7%.Conclusion:Patellar fracture treated with cable pin has the advantages of simple manipulation,firm fixation,faster and guaranteed fracture heeling and good function of knee.The method meets the demands of biomechanics and the clinical result of this group is quite satisfactory.It is advisable to use it in clinical practice.