Yang Xu, Wu Qinfen, Lai Chin-Hui, Wang Xin
Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan 430071, China.
Department of Surgery, The Affiliated Hospital of Hubei Provincial Government, East 2nd Road, Shuiguohu Road, Wuchang District, Wuhan 430071, China.
Injury. 2017 Oct;48(10):2348-2353. doi: 10.1016/j.injury.2017.07.013. Epub 2017 Jul 13.
We present a modified tension band technique combined with cable cerclage using Cable Grip System for the treatment of displaced inferior patellar pole fractures and report the knee functional outcome.
The patients who had had operative treatment of a displaced inferior patellar pole fracture (AO/OTA 34-A1) between December 2013 and December 2015 were studied retrospectively. Eleven consecutive patients had had open reduction and internal fixation with the modified technique using Cable Grip System, of whom, five males and six females with an average age of 60.9 years (range, 29-81 years). All fractures occurred from direct fall onto the knee. The average time from injury to surgery was 6.1days (range, 2-12days). The range of motion (ROM) was measured in degrees by goniometry at postoperative intervals of 1, 2, 4, 12, and 48 weeks; Knee function was evaluated using the Rasmussen scores at final follow-up.
No patients had nonunion, loss of reduction, migration of wire, irritation from the implant and fixation breakage during the follow-up period. Recovery of ROM was achieved at 12 weeks, with the average ROM at 1 week was 72° (range, 65°-78°), 86.4° (range, 78°-92°) at 2 weeks, 115.5° (range, 103°-122°) at 4 weeks, 129.6° (range, 122°-133°) at 12 weeks, 134.5° (range, 129°-139°) at 48 weeks after the operation. Concerning the knee function outcome assessment, all patients showed excellent results at final follow-up. The average Rasmussen scores was 27.9 out of 30 (range, 27-29).
The modified tension band technique combined with cable cerclage using Cable Grip System for displaced inferior patellar pole fractures can provide stable fixation with excellent results in knee function, allows for immediate mobilization and early weight-bearing, which is a simple and valuable technique in routine clinical practice.
我们介绍一种改良张力带技术，联合使用缆索固定系统的缆索环扎术治疗移位的髌骨下极骨折，并报告膝关节功能结果。
回顾性研究2013年12月至2015年12月间接受手术治疗的移位髌骨下极骨折（AO/OTA 34-A1）患者。连续11例患者采用改良技术联合缆索固定系统进行切开复位内固定，其中男性5例，女性6例，平均年龄60.9岁（范围29-81岁）。所有骨折均因膝关节直接着地所致。受伤至手术的平均时间为6.1天（范围2-12天）。术后1、2、4、12和48周采用测角器测量活动度（ROM）；末次随访时采用Rasmussen评分评估膝关节功能。
随访期间无患者出现骨不连、复位丢失、钢丝移位、植入物刺激及内固定断裂。术后12周实现ROM恢复，术后1周平均ROM为72°（范围65°-78°），2周时为86.4°（范围78°-92°），4周时为115.5°（范围103°-122°），12周时为129.6°（范围122°-133°），48周时为134.5°（范围129°-139°）。关于膝关节功能结果评估，所有患者在末次随访时均显示出优异结果。平均Rasmussen评分为27.9分（满分30分，范围27-29分）。
改良张力带技术联合使用缆索固定系统的缆索环扎术治疗移位的髌骨下极骨折，可提供稳定固定，膝关节功能结果优异，允许早期活动和早期负重，是常规临床实践中一种简单且有价值的技术。
