Singh Saurabh, Surana Rishabh, Rai Alok, Sharma Divyansh
Department of Orthopedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India.
Indian J Orthop. 2020 Nov 9;55(3):655-661. doi: 10.1007/s43465-020-00302-4. eCollection 2021 Jun.
Tension band wiring supposedly is the most commonly used technique for displaced patella fractures, but is not effective in comminuted fractures and osteoporotic bones. It often leads to loosening of wires, dislocation of fracture, hardware problem and failure of osteosynthesis, resulting in knee stiffness and post-traumatic osteoarthritis. The aim of the study is to evaluate clinical outcome in patients with acute patella fractures (< 3 week) treated with unidirectional angle fixed low-profile titanium patella locking plate.
Twenty patients who presented with displaced patella fractures, aged between 18-70 years were included in the study. All fractures were reduced and fixed with unidirectional angle fixed stable low-profile titanium patella locking plate. Knee Range of motion and Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL) was used to evaluate the outcome.
We were able to achieve union in 19 out of 20 patients. One patient with comminuted patella fracture had failure of fixation, which was revised. Mean flexion at final follow-up was 124° (110°-130°) and none of the patients had extensor lag. The final radiograph revealed complete union in all patients.
This technique offers an option of fixation in comminuted patella fracture and in osteoporotic individuals. It provides mechanical stability for fracture fixation resulting in anatomical reduction, good functional outcome, lower incidence of symptomatic implant or failure of osteosynthesis.
张力带钢丝固定术据说是治疗髌骨移位骨折最常用的技术，但对粉碎性骨折和骨质疏松性骨无效。它常常导致钢丝松动、骨折移位、内固定问题及骨愈合失败，从而导致膝关节僵硬和创伤后骨关节炎。本研究的目的是评估采用单向角固定低轮廓钛髌骨锁定钢板治疗急性髌骨骨折（<3周）患者的临床疗效。
本研究纳入20例年龄在18 - 70岁之间的髌骨移位骨折患者。所有骨折均采用单向角固定稳定低轮廓钛髌骨锁定钢板进行复位和固定。采用膝关节活动范围和膝关节日常生活活动量表（KOS - ADL）评估疗效。
20例患者中有19例实现骨折愈合。1例髌骨粉碎性骨折患者固定失败，进行了翻修。末次随访时平均屈曲角度为124°（110° - 130°），所有患者均无伸肌滞后。最终X线片显示所有患者均实现完全愈合。
该技术为粉碎性髌骨骨折及骨质疏松患者提供了一种固定选择。它为骨折固定提供了机械稳定性，从而实现解剖复位、良好的功能结局、症状性植入物或骨愈合失败的发生率较低。
