Separate vertical wiring combined with tension band and Kirschner-wire plus cer-clage wire in the treatment of displaced inferior pole fractures of the patella / 北京大学学报(医学版)

ABSTRACT

Objective:To investigate the clinical efficacy and outcomes of two separate vertical wiring combined with tension band and Kirschner-wire plus cerclage wire in the treatment of displaced inferior pole fractures of the patella.Methods:From January 201 3 to January 201 5,1 5 consecutive patients (mean age 54.5 years)with inferior pole fractures of the patella were retrospectively included in this study.All the patients underwent open reduction and internal fixation by separate vertical wiring com-bined with tension band and Kirschner-wire plus cerclage wire through longitudinal incision,4.5 d (range3.1 -5.9 d)after initial injury.A safety check for early knee range of motion was performed before wound closure.The complications including infection,nonunion,loss of fixation and any wire breakage or irritation from implant were recorded.Anteroposterior and lateral views of the knee joint ob-tained during the follow-up were used to assess bony union based on the time when the fracture line disap-peared.At the time of the final outpatient follow up,functional evaluation of the knee joint was conduc-ted by B?stman system.Results:The follow-up time was 1 3.1 months (range1 2 -1 9 months)after surgery on average,immediate motion without immobilization in all the cases was allowed and there was no case of reduction loss of the fracture and wire breakage.There was no case of irritation from the im-plant.At the final follow-up,the average range of motion (ROM)arc was 1 26.7°(range1 1 5°-1 40°),the average ROMlag versus contralateral healthy leg was 1 0.3°(range0°-35°).The mean B?stman score at the last follow-up was 28.9 (range27 -30),and graded excellent in most cases. Conclusion:Two separate vertical wiring is an easy and effective method to reduce the displaced inferior pole fracture of patella.Augmentation of separate vertical wiring with tension band and Kirschner-wire plus cerclage wire in these patients provides enough strength to protected the early exercise of the knee joint and uneventful healing.By this surgical treatment,excellent results in knee function can be expec-ted for cases of displaced inferior pole fractures of the patella.