Kumar Sumit, Mittal Samarth, Manhas Vikrant, Sharma Vijay
All India Institute of Medical Sciences, New Delhi, India.
Injury. 2022 Feb;53(2):691-697. doi: 10.1016/j.injury.2021.11.053. Epub 2021 Nov 25.
Patellar fractures constitute almost 1% of total skeletal injuries. Existing common operative methods include the use of different types of Tension band wiring techniques like cannulated screws and K-wires. The Patellar plating construct is a relatively newer operative method for patellar fracture fixation with promising outcomes with fewer complications.
We conducted a pilot prospective study at our Apex Trauma center in twenty patients aged 18-65years with displaced patellar fractures, AO type A2, A3, B2, B3, C1, C2, C3. Fractures were fixed with low profile patellar plates (1.8 mm). Radiological and functional follow-up was done using X-rays, CT scans and BKS scoring (Bostman-Knee-Scale), Knee Society Score(KSS), and Tegner Lysholm knee scores respectively for two years.
Mean functional outcome scores at 6 weeks, 3 months, 6 months and 2 years was 25.5, 28.3, 29.05 and 29.9 for BKS; 64.62, 84.12, 90.6, and 97.5 for KSS; 73.75, 89.7,94.8, and 99.3 for Tegner Lysholm knee score respectively. Radiological union, confirmed by CT scan, was observed in all patients at 3 months. Two patients had superficial surgical site infection (SSI) at 2 weeks. Implant impingement was also found in 2 patients at 3 months. None of the patients had a failure of fixation at the end of the study.
Patients with low profile patellar plate constructs have favorable clinical and radiological outcomes with minimal non-specific complications.
髌骨骨折约占全身骨骼损伤的1%。现有的常见手术方法包括使用不同类型的张力带钢丝技术，如空心螺钉和克氏针。髌骨钢板固定是一种相对较新的治疗髌骨骨折的手术方法，疗效良好，并发症较少。
我们在顶级创伤中心对20例年龄在18 - 65岁、髌骨骨折移位（AO分型为A2、A3、B2、B3、C1、C2、C3）的患者进行了一项前瞻性初步研究。骨折采用薄型髌骨钢板（1.8毫米）固定。分别使用X线、CT扫描以及BKS评分（博斯特曼膝关节评分）、膝关节协会评分（KSS）和泰格纳·利绍姆膝关节评分进行为期两年的影像学和功能随访。
BKS评分在6周、3个月、6个月和2年时的平均功能结果分别为25.5、28.3、29.05和29.9；KSS评分分别为64.62、84.12、90.6和97.5；泰格纳·利绍姆膝关节评分分别为73.75、89.7、94.8和99.3。CT扫描证实所有患者在3个月时达到影像学愈合。2例患者在术后2周出现浅表手术部位感染（SSI）。3个月时也发现2例患者存在植入物撞击。在研究结束时，没有患者出现内固定失败。
采用薄型髌骨钢板固定的患者具有良好的临床和影像学结果，非特异性并发症最少。
