Department of Orthopaedics, The Third Hospital of Mianyang· Sichuan Mental Health Center, Mianyang, China.
Orthop Surg. 2022 Nov;14(11):3092-3099. doi: 10.1111/os.13518. Epub 2022 Oct 4.
Most inferior pole fractures of the patella are comminuted. Therefore, an ideal treatment method has not been determined. We have presented a modified tension band fixation technique-the Krachow suturing, Nice knot combined with tension band fixation-and reported the results of the procedure.
A total of 16 inferior patellar pole fractures were treated at our institution between January 2019 and October 2020, 15 of which underwent treatment with the modified tension band fixation technique consisting of Krachow suturing with Nice knots combined with tension band fixation. The primary measures: knee motion, Bostman score, anterior knee pain, fixation failure.
Bone union occurred at a mean of 9 weeks postoperatively (range: 8-13). There were no cases of postoperative anterior knee pain, refracture of the inferior patellar pole or wire breakage. The patients regained full ROM of the knee joint without functional deficits during follow-up; the mean ROM was 128.46° ± 7.07° (range: 113.4°-137.8°). At the last follow-up, all patients had a mean Bostman score of 28.40 ± 1.29 (range: 26-30), with an excellent score in 11 patients and a good score in four patients.
The modified tension band fixation technique for the treatment of inferior patellar pole fractures is a simple and easy-to-perform surgical technique that provides stable fixation and good functional results.
大多数髌骨下极骨折为粉碎性骨折。因此，尚未确定理想的治疗方法。我们提出了一种改良的张力带固定技术——Krachow 缝合、Nice 结联合张力带固定，并报告了该手术的结果。
2019 年 1 月至 2020 年 10 月，我们机构共治疗了 16 例髌骨下极骨折，其中 15 例采用改良张力带固定技术治疗，包括 Krachow 缝合、Nice 结联合张力带固定。主要评价指标：膝关节活动度、Bostman 评分、膝关节前痛、固定失败。
术后平均 9 周（813 周）骨折愈合。无术后膝关节前痛、髌骨下极再骨折或钢丝断裂。患者在随访期间恢复了膝关节的完全活动度，无功能缺陷；平均 ROM 为 128.46°±7.07°（范围：113.4°137.8°）。末次随访时，所有患者的 Bostman 评分为 28.40±1.29（范围：26~30），其中 11 例优，4 例良。
改良张力带固定治疗髌骨下极骨折是一种简单易行的手术技术，可提供稳定的固定和良好的功能结果。
