Ellwein A, Lill H, Jensen G, Gruner A, Katthagen J C
Klinik für Orthopädie und Unfallchirurgie, BG Klinikum Hamburg im DIAKOVERE Friederikenstift, Humboldtstr. 5, 30169, Hannover, Deutschland.
Orthopädische Klinik, Herzogin Elisabeth Hospital, Braunschweig, Deutschland.
Unfallchirurg. 2017 Sep;120(9):753-760. doi: 10.1007/s00113-016-0213-1.
Tension band wiring after patellar fractures is related to a high number of implant-related complications (22-53 %). Revision surgery is necessary in 10-55 % of patients mostly with unsatisfactory results. The patella plate is an alternative treatment with the advantages of locked plating. The purpose of this study was to evaluate the first clinical prospective results and complications of this new implant.
Between April 2013 and May 2015 all patients that were treated with locked plating for patella fractures were included in this prospective study. Patients were followed-up clinically after six weeks and six months.
Included in this study were 17 patients, 6 women and 11 men, with a mean age of 58 years (19-87). The knee range of motion was 120° after 6 weeks and improved to 138° after 6 months, corresponding to 84 % and 97 % of the range of motion of the healthy opposite knee. The Tegner activity scale increased from 2,5 to 3,5 (initial value: 4), the Lysholm score increased from 78 to 92 points (initial value: 97) and the Kujala score increased from 72 to 88 points (initial value: 96). Two complications occurred: one patient had a reactive bursitis prepatellaris and one patient sustained a loss of reduction.
Locked plating of patella fractures is a reliable alternative treatment with good functional outcomes and low complication rates.
髌骨骨折后张力带钢丝固定与大量植入物相关并发症有关（22%-53%）。10%-55%的患者需要进行翻修手术，且大多效果不理想。髌骨钢板是一种替代治疗方法，具有锁定钢板的优点。本研究的目的是评估这种新型植入物的首批临床前瞻性结果及并发症。
2013年4月至2015年5月期间，所有接受髌骨骨折锁定钢板治疗的患者均纳入本前瞻性研究。患者在六周和六个月后进行临床随访。
本研究纳入17例患者，其中女性6例，男性11例，平均年龄58岁（19-87岁）。六周后膝关节活动范围为120°，六个月后改善至138°，分别相当于健侧膝关节活动范围的84%和97%。Tegner活动量表从2.5提高到3.5（初始值：4），Lysholm评分从78分提高到92分（初始值：97），Kujala评分从72分提高到88分（初始值：96）。发生了2例并发症：1例患者出现髌前反应性滑囊炎，1例患者出现复位丢失。
髌骨骨折锁定钢板固定是一种可靠的替代治疗方法，功能结果良好，并发症发生率低。
