Department of Orthopaedics, Third Hospital of Peking University, Beijing 100191, China.
Clin Orthop Relat Res. 2011 Dec;469(12):3429-35. doi: 10.1007/s11999-011-1913-z. Epub 2011 May 15.
Although the modified tension band technique (eg, tension band supplemented by longitudinal Kirschner wires) has long been the mainstay for fixation of transverse fractures of the patella, it has shortcomings, such as bad reduction, loosening of implants, and skin irritation.
QUESTIONS/PURPOSES: We conducted a retrospective comparison of the modified tension band technique and the titanium cable-cannulated screw tension band technique.
We retrospectively reviewed 101 patients aged 22 to 85 years (mean, 56.6 years) with AO/OTA 34-C1 fractures (n = 68) and 34-C2 fractures (n = 33). Fifty-two patients were in the modified tension band group and 49 were in the titanium cable-cannulated screw tension band group. Followup was at least 1 year (range, 1-3 years). Comparison criteria were fracture reduction, fracture healing time, and the Iowa score for knee function.
The titanium cable-cannulated screw tension band group showed improved fracture reduction, reduced healing time, and better Iowa score, compared with the modified tension band group. In the modified tension band group, eight patients experienced wire migration, three of these requiring a second operation. There were no complications in the titanium cable-cannulated screw tension band group.
The titanium cable-cannulated screw tension band technique showed superior results and should be considered as an alternative method for treatment of transverse patellar fractures.
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
尽管改良张力带技术（例如，张力带辅以纵向克氏针）长期以来一直是固定髌骨横断骨折的主要方法，但它存在复位不良、植入物松动和皮肤刺激等缺点。
问题/目的：我们对改良张力带技术和钛缆线环扎螺钉张力带技术进行了回顾性比较。
我们回顾性分析了 101 例年龄为 22 岁至 85 岁（平均 56.6 岁）的 AO/OTA 34-C1 型骨折（n=68）和 34-C2 型骨折（n=33）患者。52 例患者接受改良张力带治疗，49 例患者接受钛缆线环扎螺钉张力带治疗。随访时间至少 1 年（范围 1-3 年）。比较标准为骨折复位、骨折愈合时间和膝关节功能的爱荷华评分。
与改良张力带组相比，钛缆线环扎螺钉张力带组骨折复位更好，愈合时间更短，爱荷华评分更高。在改良张力带组中，8 例患者出现钢丝迁移，其中 3 例需要再次手术。钛缆线环扎螺钉张力带组无并发症。
钛缆线环扎螺钉张力带技术具有更好的效果，应考虑作为治疗髌骨横断骨折的替代方法。
III 级，治疗性研究。有关证据水平的完整描述，请参见作者指南。
