Clinical Medical College of Yangzhou University, Yangzhou, China.
Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
Comput Math Methods Med. 2021 Dec 31;2021:4964195. doi: 10.1155/2021/4964195. eCollection 2021.
To evaluate the efficacy of suture anchor combined with double-pulley technique for subpatellar comminuted fractures compared with wire vertical suture and Krachow in the treatment of subpatellar fractures.
Retrospectively selected 48 patients with subpatellar pole comminuted fracture admitted in our hospital from February 2013 to July 2019, 25 patients with double-pulley technique (group A), and 23 patients with vertical wire suture with Krachow suture. Patient age, gender, AT/OTA typing, injury mechanism, follow-up time, surgical time, bleeding volume, mean fracture healing time, and postoperative complications were recorded. The Insall-Salvati index immediately and 6 weeks after surgery. Bostman scores and knee activity were recorded at each follow-up, and month 12 was taken as the final result.
Time of surgery in group A (46.52 min) was significantly shorter than in group B (76.30 min). Intraoperative bleeding in group 15.1 ml, B, group 15.9 ml. Both incisions healed in stage I, averaging clinical healing of patella fracture within 10 weeks. There was no significant difference in mean Bostman score and knee activity at month 12 (group A: 28.4, 124.8°; group B: 28.1, 125.7°). There was no significant statistical difference in the Insall-Salvati index immediately or 6 weeks between the two groups. Group B patients had two wire fractures, fracture healing and the wire removed one year after surgery, and the remaining patients had no complications such as internal fixation loosening, fracture, delayed healing, or nonhealing of fracture.
Compared with the treatment of subpatellar fracture with wire vertical suture and Krachow method, suture anchor with double-pulley technique has short operation time, reliable fixation, and less complications. Patients can have early functional exercise and good knee function recovery without secondary surgery. It can be considered as an alternative therapy for this fracture and deserves clinical adoption and promotion.
评估缝线锚钉联合双滑线技术治疗髌骨下极粉碎性骨折的疗效，与钢丝垂直缝合加克氏针缝合相比。
回顾性分析 2013 年 2 月至 2019 年 7 月我院收治的 48 例髌骨下极粉碎性骨折患者，采用双滑线技术治疗 25 例（A 组），采用钢丝垂直缝合加克氏针缝合 23 例（B 组）。记录患者年龄、性别、AT/OTA 分型、损伤机制、随访时间、手术时间、出血量、平均骨折愈合时间、术后并发症。术后即刻及 6 周测量 Insall-Salvati 指数，Bostman 评分及膝关节活动度，并于术后 12 个月作为最终结果。
A 组手术时间（46.52 分钟）明显短于 B 组（76.30 分钟）。A 组术中出血量 15.1ml，B 组 15.9ml。两组切口均一期愈合，平均髌骨骨折临床愈合时间为 10 周。术后 12 个月，Bostman 评分和膝关节活动度平均（A 组：28.4、124.8°；B 组：28.1、125.7°）差异无统计学意义。两组术后即刻及 6 周 Insall-Salvati 指数差异无统计学意义。B 组有 2 例钢丝断裂，1 例术后 1 年骨折愈合钢丝取出，其余患者均无内固定松动、骨折、延迟愈合或骨折不愈合等并发症。
与钢丝垂直缝合加克氏针缝合治疗髌骨下极骨折相比，缝线锚钉联合双滑线技术操作时间短，固定可靠，并发症少。患者可早期进行功能锻炼，膝关节功能恢复良好，无需二次手术。可作为治疗此类骨折的一种替代方法，值得临床采用和推广。
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