Huang Wenzhou, Wu Tianlong, Wei Qiangqiang, Peng Longhai, Cheng Xigao, Gao Guicheng
Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.
Institute of Orthopedics of Jiangxi Province, Nanchang, Jiangxi 330006, P.R. China.
Exp Ther Med. 2021 Sep;22(3):998. doi: 10.3892/etm.2021.10430. Epub 2021 Jul 15.
Patellar inferior pole fracture is difficult to treat due to the inherent weakness of small comminuted distal fragments. However, suture fixation was recently introduced and reported. The aim of the present study was to evaluate and compare the clinical outcomes of two suture techniques, transosseous tunnel suture (TTS) and anchor suture (AS), for the fixation of patellar inferior pole fracture. A total of 35 patients with patellar inferior pole fracture treated at the Second Affiliated Hospital of Nanchang University (Nanchang, China) between June 2014 and April 2018 were retrospectively reviewed. Of these, 14 were treated with the TTS technique and 21 using AS fixation. The operation time, incision length and total cost were determined and compared. Functional outcomes were analyzed with the visual analog scale (VAS), Bostman and Lysholm scores and knee joint ranges of motion (ROMs). Postoperative complications were also observed and recorded. The mean follow-up was 22.6±9.7 and 18.7±5.9 months for TTS and AS, respectively. The groups were similar regarding age, sex, operative side and time to surgery. A smaller incision length and shorter operation time but higher hospital costs were observed in the AS group (P<0.01). For functional evaluation, there was no significant difference in VAS, Bostman and Lysholm scores or ROM between the 2 groups (P>0.05). No postoperative complications were observed in the TTS group. Only one patient in the AS group experienced a superficial minor wound infection. The TTS and AS techniques provided similarly satisfactory clinical outcomes for treating patellar inferior pole fracture. TTS had the advantage of cost-effectiveness due to saving anchors, while AS had a shorter operation time and a smaller incision length.
髌骨下极骨折因远端小碎骨块固有的薄弱性而难以治疗。然而，缝线固定术最近被引入并报道。本研究的目的是评估和比较两种缝线技术，即经骨隧道缝线（TTS）和锚钉缝线（AS），用于固定髌骨下极骨折的临床疗效。回顾性分析了2014年6月至2018年4月在南昌大学第二附属医院（中国南昌）接受治疗的35例髌骨下极骨折患者。其中，14例采用TTS技术治疗，21例采用AS固定。确定并比较手术时间、切口长度和总费用。采用视觉模拟量表（VAS）、Bostman和Lysholm评分以及膝关节活动范围（ROM）分析功能结果。还观察并记录术后并发症。TTS组和AS组的平均随访时间分别为22.6±9.7个月和18.7±5.9个月。两组在年龄、性别、手术侧和手术时间方面相似。AS组的切口长度较小，手术时间较短，但住院费用较高（P<0.01）。在功能评估方面，两组之间的VAS、Bostman和Lysholm评分或ROM没有显著差异（P>0.05）。TTS组未观察到术后并发症。AS组只有1例患者发生浅表轻微伤口感染。TTS和AS技术在治疗髌骨下极骨折方面提供了同样令人满意的临床结果。TTS因节省锚钉而具有成本效益优势，而AS的手术时间较短，切口长度较小。
