Department of Orthopedics, The Second Hospital of Anhui Medical University, Hefei, China.
Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China.
Orthop Surg. 2022 Feb;14(2):374-382. doi: 10.1111/os.13124. Epub 2021 Dec 29.
The study aim was to evaluate the clinical outcomes, functional outcomes, and postoperative complications of anchor and Krackow-"8" suture fixation (AS) and K-wire fixation in patients with distal pole patellar fractures.
Twenty-eight patients with distal pole patella fractures between January 2011 and December 2014 were reviewed retrospectively. The anchor and Krackow-"8" suture fixation (AS group) was applied in 10 patients and 18 patients underwent K-wire fixation (K-wire group). The average age of patients was 46.000 ± 19.476 years in the AS group and 47.556 ± 15.704 years in the K-wire group, with comparable demographic characteristics. All patients underwent regular follow-up the operative data and postoperative functional and clinical outcomes were recorded. Complications were recorded by clinical and radiographic assessment. Bostman patellar fracture functional score was used to evaluate knee function after patellar fracture.
A total of 28 eligible patients were included in this study. The mean follow-up was similar for the AS and the K-wire groups (P > 0.05). The incision length of AS group was significantly smaller than that of K-wire group (P < 0.05). The incision length of AS group was significantly smaller than that of K-wire group (P < 0.05). The final follow-up on the range of motion of the knee: the average extension lag was similar in two groups (P > 0.05); flexion and flexion-extension angle was slightly better in the AS group than in the K-wire group. The Bostman patella fracture functional score of AS group were better than K-wire group at 3 and 6 months after operation. Four kinds of postoperative complications in two groups, one patient (10%) in the AS group and two patients (11.1%) in the K-wire group had infections. Two (11.1%) cases of nonunion in group K and three patients (16.7%) required re-operation: one due to infection and two due to early implant failure. In the AS group, all distal pole fractures of the patella showed bony union, without loosening, falling, pulling out and nonunion of the fractures 6 months after operation.
Anchor and Krackow-"8" suture fixation is an easily executed surgical procedure that can significantly reduce incision length and achieve better surgical outcomes than traditional procedures with regard to postoperative complications, knee function and without requiring a second operation. This technique is an effective operation method for the treatment of inferior patellar pole fractures.
评估锚定和 Krackow-“8”缝线固定（AS）与克氏针固定治疗髌骨下极骨折的临床结果、功能结果和术后并发症。
回顾性分析 2011 年 1 月至 2014 年 12 月收治的 28 例髌骨下极骨折患者，其中采用锚定和 Krackow-“8”缝线固定（AS 组）10 例，采用克氏针固定（K 线组）18 例。AS 组患者平均年龄为 46.000±19.476 岁，K 线组患者平均年龄为 47.556±15.704 岁，两组患者的人口统计学特征具有可比性。所有患者均接受常规随访，记录手术数据，术后随访功能和临床结果。通过临床和影像学评估记录并发症。采用 Bostman 髌骨骨折功能评分评估髌骨骨折后膝关节功能。
本研究共纳入 28 例符合条件的患者。AS 组和 K 线组的平均随访时间相似（P＞0.05）。AS 组的切口长度明显小于 K 线组（P＜0.05）。AS 组的最终随访膝关节活动度：两组平均伸膝迟滞相似（P＞0.05）；AS 组的屈伸和屈伸角度稍优于 K 线组。术后 3 个月和 6 个月时，AS 组的 Bostman 髌骨骨折功能评分优于 K 线组。两组均出现 4 种术后并发症，AS 组 1 例（10%）和 K 线组 2 例（11.1%）感染。K 组 2 例（11.1%）骨不连，3 例（16.7%）需再次手术：1 例因感染，2 例因早期植入物失败。AS 组所有髌骨下极骨折均骨性愈合，无骨折松动、脱落、拔出和不愈合，术后 6 个月。
锚定和 Krackow-“8”缝线固定是一种易于实施的手术方法，与传统方法相比，可明显减少切口长度，并在术后并发症、膝关节功能方面取得更好的手术效果，且无需再次手术。该技术是治疗髌骨下极骨折的有效手术方法。
