Department of Orthopedics, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
J Trauma Acute Care Surg. 2012 Apr;72(4):1056-61. doi: 10.1097/TA.0b013e318240d728.
Transverse patella fractures are the most common type of patella fractures. Minimally invasive surgical technique for treatment of transverse patella fractures with the Cable Pin System has not been previously reported.
Thirty-four patients with displaced transverse fractures of the patella were included in this prospective study and were operatively treated by the Cable Pin System with a minimally invasive technique. Postoperative evaluation was based on radiographs, Visual Analog Scale of pain, range of motion, and Bostman grading scale.
A total of 31 patients were finally included, with an average follow-up period of 21 months. The average operation time was 48 minutes. Intraoperative fluoroscopy was used for 2 to 4 times (average: 2.4 times). Radiographic evidence of solid fracture union was observed in all cases in a mean period of 7.2 weeks. The Visual Analog Scale score for pain was 3.3 ± 1.4 and 1.5 ± 1.3 at 4 weeks after surgery and when radiographic fracture healing was achieved, respectively. Twenty-nine patients achieved full knee range of motion, while two patients had 10° loss of full flexion at the final follow-up visit. The average Bostman score was 29.1/30 (range, 27-30) at 1 year after surgery, and an evaluation of "excellent" was observed in 30 patients at the final follow-up visit.
Surgical treatment of transverse patella fractures by the Cable Pin System with a minimally invasive technique was shown to provide satisfactory clinical results and excellent knee functions, with less pain and low incidence of complications. It could be a new option for treatment of transverse patella fractures.
横断髌骨骨折是最常见的髌骨骨折类型。采用 Cable Pin 系统微创技术治疗横断髌骨骨折的方法尚未见报道。
本前瞻性研究纳入了 34 例移位性横断髌骨骨折患者,采用 Cable Pin 系统微创技术进行手术治疗。术后评估基于影像学、疼痛视觉模拟评分、关节活动度和 Bostman 分级。
共有 31 例患者最终纳入研究,平均随访 21 个月。平均手术时间为 48 分钟。术中透视使用 2-4 次(平均 2.4 次)。所有病例在平均 7.2 周的时间内均观察到骨折愈合的影像学证据。术后 4 周和影像学骨折愈合时,疼痛视觉模拟评分分别为 3.3±1.4 和 1.5±1.3。29 例患者膝关节活动度完全恢复,2 例患者在末次随访时存在 10°的完全屈曲丧失。术后 1 年的平均 Bostman 评分为 29.1/30(范围 27-30),末次随访时 30 例患者评估为“优秀”。
采用 Cable Pin 系统微创技术治疗横断髌骨骨折可获得满意的临床结果和优良的膝关节功能,疼痛较轻,并发症发生率低。它可能成为治疗横断髌骨骨折的一种新选择。