Clinical analysis of arthroscopic minimally invasive Kirschner wire tension band internal fixation for transverse patellar fracture / 中国综合临床

ABSTRACT

Objective:To investigate the clinical effect of arthroscopic minimally invasive Kirschner wire tension band internal fixation in the treatment of transverse patellar fracture.Methods:From March 2016 to March 2018, 108 patients with transverse patellar fracture admitted to the Department of orthopedics, Linxi hospital, Kailuan general hospital, Hebei Province were analyzed retrospectively.According to the different operation methods, the patients were divided into arthroscopic group (68 cases) and control group (40 cases). The patients in the arthroscopic group were treated with arthroscopic minimally invasive Kirschner wire tension band internal fixation, and the patients in control group were treated with open reduction and Kirschner wire tension band internal fixation.The operation condition, clinical efficacy, Lysholm score and visual analogue scale(VAS) score were compared between the two groups.Results:The incision length((3.5±0.8) cm) of arthroscopic group was shorter than that of control group((13.7±2.2) cm), the amount of intraoperative bleeding ((47.4±12.5) ml) was significantly less than that of control group ((86.9±14.7) ml), and the length of hospitalization((11.8±2.6) d) and fracture healing time ((11.5±2.4) weeks)were significantly less than those in control group ((15.8±3.0) d, (15.7±2.8) weeks), the difference was statistically significant( t value were 34.63, 14.85, 7.29, 8.25; all P<0.05). The Lysholm score of two groups increased significantly with time( Fintra-group=87.53, P<0.05). The increasing of Lysholm score in arthroscopic group was significantly higher than that in control group( Finteraction=7.64, P<0.05). The overall level of Lysholm in arthroscopic group was significantly higher than that of control group( Finter-group=11.42, P<0.05). The VAS score of two groups decreased significantly with time( Fintra-group=76.47, P<0.05). The decreased of VAS score in arthroscopic group was significantly higher than that in control group( Finteraction=9.96, P<0.05). The overall level of VASin arthroscopic group was significantly lower than that of control group( Finter-group=10.38, P<0.05). Conclusion:Arthroscopic minimally invasive Kirschner wire tension band internal fixation for the treatment of transverse patellar fracture has better efficacy and safety, less injury, less pain after operation.