Meng Depeng, Xu Peng, Shen Di, Chen Yu, Zhu Chengdong, Hou Chunlin, Lin Haodong, Ouyang Yueping
Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China.
Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China; Department of Orthopedics, The People's Hospital of Yizheng City, Jiangsu, PR China.
J Orthop Sci. 2019 Jan;24(1):142-146. doi: 10.1016/j.jos.2018.08.026. Epub 2018 Oct 11.
Tension bands structures are widely used to treat transverse patellar fractures. However, many implants-related complications have been reported. The purpose of this study is to evaluate effects and compare complications of three methods used to treat transverse patellar fractures, including titanium cable tension bands, compression screws with titanium cable cerclage, and X-shaped plating technique.
From January 2010 to March 2016, 120 cases of transverse patellar fracture received open reduction and internal fixation with one of three methods: titanium cable tension band (group A), compression screws with titanium cable cerclage (group B), and X-shaped plating technique (group C). Of these, 108 cases were followed for >2 years. Clinical and radiographic data were retrospectively collected and statistically compared.
Final analysis included 108 patients (n = 38 in group A, 36 in B, and 34 in C). Reduction was satisfactory in all patients after surgery. No significant differences were noted in age, gender, time from injury to surgery, postoperative articular step-off, Lysholm score, and range of motion at 24 months among all groups. At final follow-up, 12 (31.6%) symptomatic implant complications were encountered in group A, along with 6 (16.7%) and 2 (5.9%) in groups B and C, respectively (p < 0.05).
All three methods could achieve the goal of rigid fixation and early functional rehabilitation. However, the X-plate technique had the lowest risk of symptomatic implant complications and could thus be a safe and effective alternative for internal fixation of transverse patellar fractures.
张力带结构广泛应用于治疗髌骨横行骨折。然而，已报道了许多与植入物相关的并发症。本研究的目的是评估三种用于治疗髌骨横行骨折的方法的效果并比较其并发症，这三种方法包括钛缆张力带、带钛缆环扎的加压螺钉以及X形钢板技术。
2010年1月至2016年3月，120例髌骨横行骨折患者接受了切开复位内固定术，采用以下三种方法之一：钛缆张力带（A组）、带钛缆环扎的加压螺钉（B组）和X形钢板技术（C组）。其中，108例患者随访时间超过2年。回顾性收集临床和影像学数据并进行统计学比较。
最终分析纳入108例患者（A组38例，B组36例，C组34例）。所有患者术后复位均满意。所有组之间在年龄、性别、受伤至手术时间、术后关节台阶、Lysholm评分以及24个月时的活动范围方面均未发现显著差异。在末次随访时，A组出现12例（31.6%）有症状的植入物并发症，B组和C组分别为6例（16.7%）和2例（5.9%）（p<0.05）。
所有三种方法均可实现坚强固定和早期功能康复的目标。然而，X形钢板技术出现有症状的植入物并发症的风险最低，因此可能是髌骨横行骨折内固定的一种安全有效的替代方法。
