Orthopaedic Unit and Kirk-Kilgour Sports Injury Centre, S. Andrea Hospital, University of Rome La Sapienza, Via di Grottarossa, 1035, 00189 Rome, Italy.
Kansas City University of Medicine and Biosciences, Kansas City, MO, USA.
Orthop Traumatol Surg Res. 2022 Nov;108(7):103053. doi: 10.1016/j.otsr.2021.103053. Epub 2021 Sep 13.
Several surgical techniques have been proposed for the treatment of patellar fractures. The aim of this study is to compare the clinical efficacy and complication rates of treatment using suture tape circumferential cerclage (STCC) and metallic wire circumferential cerclage (MWCC) for the surgical treatment of displaced transverse patellar fractures (TPFs).
The hypothesis is that the use of the suture tape would be associated with a significantly lower rate of re-operation than metallic cerclage but no differences in other clinical outcomes.
A retrospective comparative analysis of the clinical outcomes of consecutive patients undergoing fixation of TPFs with either MWCC or STCC between January 2017 and December 2018 was undertaken. All patients underwent evaluation with standardised radiographs at one, three, and six months after surgery to determine rates of union, non-union, loss of fixation and malunion. All patients underwent a final clinical evaluation at 18 months postoperatively to evaluate clinical scores and complications.
A total of 26 patients were included in the study. Thirteen patients underwent STCC and 13 underwent MWCC. There were no complications in the STCC group. In the MWCC group, one patient underwent hardware removal at 2 months postoperatively due to painful prominence. There was no significant difference in re-operation rates between the STCC and MWCC groups (p=1). There were no cases of non-union, malunion or loss of fixation throughout the series. At the final clinical follow-up of 18months, there were no significant differences in KSS, KOOS or Böstman scores between the groups.
No significant differences were identified when comparing the clinical outcomes of fixation of AO/OTA 34C1/2 fractures with suture tape or metallic cerclage fixation concerning re-operation rates, union rates, loss of fixation and functional outcome measures. These results cannot be extrapolated to more complex injury patterns or surgical techniques in which prominence of implanted material is more likely.
III.
已有多种外科技术被用于治疗髌骨骨折。本研究旨在比较缝线环绕环扎（STCC）和金属线环绕环扎（MWCC）治疗移位型横断髌骨骨折（TPF）的临床疗效和并发症发生率。
假设缝线环绕环扎的再次手术率明显低于金属环扎，但其他临床结局无差异。
回顾性分析了 2017 年 1 月至 2018 年 12 月期间连续接受 MWCC 或 STCC 固定治疗的 TPF 患者的临床结果。所有患者均在术后 1、3 和 6 个月接受标准 X 线检查，以确定愈合率、不愈合率、固定丢失和畸形愈合率。所有患者在术后 18 个月进行最终临床评估，以评估临床评分和并发症。
共纳入 26 例患者。13 例患者行 STCC，13 例行 MWCC。STCC 组无并发症。MWCC 组 1 例患者术后 2 个月因金属突出出现疼痛而行内固定物取出术。两组再次手术率无显著差异（p=1）。本系列中无不愈合、畸形愈合或固定丢失病例。在最终的 18 个月临床随访中，两组间 KSS、KOOS 或 Böstman 评分无显著差异。
在比较使用缝线环绕环扎或金属环扎固定 AO/OTA 34C1/2 型骨折的临床结果时，未发现再次手术率、愈合率、固定丢失和功能结果测量方面存在显著差异。这些结果不能外推至更复杂的损伤模式或更可能出现植入物突出的手术技术。
III 级。
