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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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Fracture mapping, also known as mapping of fracture lines, is a technique of drawing fracture lines based on 3D reconstruction of radiological images. Fracture mapping can be used to describe fracture morphology, calculate fracture line angle and fragment area, improve clinical practice, propose a new classification system, clarify a fracture mechanism, and establish a model of bone fracture. At present, fracture mapping has become a powerful tool for study of morphology and clinical decision in orthopaedics. Reviewing the development of fracture mapping techniques, this paper addresses their clinical application in knee injuries, tibial plateau fracture, distal femur fracture and patellar fracture in particular. In addition, considering the trend of fracture mapping techniques and the morphology-related studies at present, we offer suggestions concerning improvement of techniques and morphology studies in knee injuries.
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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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This study is aimed to evaluate advantages and disadvantages of patella fracture fixation technique with figure-of-eight tension band, then draw indications and contra-indications of this technique. Subjects: 80 patients with occult patella fracture treated at Traumatic-Orthopedic Department, Hospital No 103 from January 1980 to July 1996. Postoperative outcomes: very good: 56 cases (76.87%), good: 7 cases (9.85%), fair: 6 cases (8.45%), and bad: 2 cases (2.80%)
Subject(s)
Fractures, Bone , Therapeutics , PatellaABSTRACT
Fractures of the patella are intra-articular fractures of a sesamoid bone. The goal of treatment is to restore the function of the extensor mechanism and congtvity of the articular surface of the knee. So postoperative traumatic arthritis is minimized by an accurate reduction of the articular surfaces. We analyzed nine cases of the patella fractures which were treated by the use of arthroscopy to allow visualization of and working inside of joints, and the use of the image-intensifier fluoroscope to allow real-time vi.sualization of the skeleton. The results were as follows The fixation of patelia fractures using an arthroscopy could be applied to transverse or vertical fractures without comminution and severe osteoporosis. 2. In the treatment of two types of patella fractures (simple transverse e rnarginal vertical fractures without comminution), clinically satisfactory results were obtained through the accurate reduction of articular surface using an arthroscopy and image intensifier.