ABSTRACT
OBJECTIVE: To investigate the effectiveness of non-absorbable suture cerclage combined with patella claw fixation for the treatment of inferior patella fractures. METHODS: Between September 2016 and January 2019, 22 patients with inferior patella fractures were treated. There were 12 males and 10 females, with a mean age of 49.1 years (range, 32-67 years). The causes of injury were traffic accident in 8 cases, falling in 12 cases, and other causes in 2 cases. The interval from injury to operation was 3-7 days (mean, 4.4 days). For the operation, 3 or 4 longitudinal tunnels were drilled backward from the surface of the proximal fracture fragment with Kirschner wires; under the guidance of lumbar puncture needles and steel wires, non-absorbable suture passed through the tunnels and encircled the inferior fracture fragment, then tighten to achieve a satisfactory reduction of the fracture; finally, the patella claw was used to strengthen the fixation. During the follow-up, complications were observed, maximum motion range of the knee joint was measured, X-ray examination was performed and fracture healing time was recorded. The knee function was evaluated according to Böstman scores. RESULTS: All the 22 patients were followed up 12-36 months (mean, 19.4 months). No infection, joint stiffness, bone nonunion, loss of reduction, or displacement of internal fixation occurred. All fractures were clinically healed, and the bone healing time was 2-3 months (mean, 2.6 months). At last follow-up, the maxium motion range of knee joint was 130°-135°, with an average of 132.6°. The Böstman score of the affected knee was 28-30 (mean, 29.2). All cases were graded as excellent results. CONCLUSION: Non-absorbable suture cerclage combined with patella claw fixation for inferior patella fractures has the advantages of simple operation, reliable fixation, and few complications, and the clinical results are satisfactory.
Subject(s)
Fractures, Bone , Patella , Adult , Aged , Bone Wires , Female , Fractures, Bone/surgery , Humans , Male , Middle Aged , Patella/surgery , Sutures , Treatment OutcomeABSTRACT
Objective To establish a 3D finite element model of an anti-shearing force Ni-Ti memory shape alloy patella claw for fixing patellar fracture, and analyze its mechanical performance. Methods The internal fixation model of transverse patellar fracture by patella claw was established by Pro/E 5.0, and then imported it into ABAQUS 10.1 for finite element analysis on its mechanical properties. The mechanical performance and deformation of the patella claw under two different patella femoral joint forces FQ at the knee flexion angle of 30°, 60°, 90° were analyzed, respectively. Results Under the same boundary condition, with the respective FQ as 367.5 N and 3 675 N, the maximum displacements of deformation were different at different flexion angles. As compared to fixation by tension band, using patella claw was preferable, with stronger resistance to tension and more stable anti-shearing force. Conclusions Deformation and displacement of the patella claw are in accordance with the biomechanical results needed in clinic, and its stability can satisfy clinical requirements for functional exercise as early as possible.
