Liu Chendong, Hu Sunjun, Chang Shimin
Department of Orthopaedics, Yangpu Hospital, Tongji University School of Medicine, Shanghai, 200090, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Jan 15;37(1):115-119. doi: 10.7507/1002-1892.202210021.
To summarize the surgical treatment methods and progress of inferior patellar pole fractures and provide reference for clinical application.
The literature on surgical treatment of inferior patellar pole fractures was extensively reviewed, and the relevant research progress, advantages, and limitations were summarized.
The inferior pole of the patella is an important part of the knee extension device, which can strengthen the force arm of the quadriceps. Inferior patellar pole fractures are relatively rare and often comminuted, usually requiring surgical treatment. At present, there are various methods to treat inferior patellar pole fractures, including patellectomy of inferior pole, tension-band wiring technique, plate internal fixation, suture anchor fixation, claw-like shape memory alloy, separate vertical wiring technique. Different methods have their own characteristics, advantages, and disadvantages. The single internal fixation method has more complications and is easy to cause fixation failure. Therefore, the trend of combining various internal fixation methods is developing at present.
When the main fragment of the inferior patellar pole fracture is large and mainly distributed transversely, the combination protocol based on tension-band wiring technique can be regarded as an ideal choice. When the fragments are severely damaged and small, the comprehensive protocol based on suture fixation can result in a better postoperative functional recovery.
总结髌骨下极骨折的手术治疗方法及进展,为临床应用提供参考。
广泛查阅髌骨下极骨折手术治疗的文献,总结相关研究进展、优点及局限性。
髌骨下极是膝关节伸展装置的重要组成部分,可增强股四头肌的力臂。髌骨下极骨折相对少见,且常为粉碎性骨折,通常需要手术治疗。目前,治疗髌骨下极骨折的方法多样,包括下极髌骨切除术、张力带钢丝技术、钢板内固定、缝线锚钉固定、爪形记忆合金、单独垂直钢丝技术。不同方法各有特点、优缺点。单一内固定方法并发症较多,易导致固定失败。因此,目前多种内固定方法联合应用的趋势正在发展。
当髌骨下极骨折的主要骨折块较大且主要呈横行分布时,基于张力带钢丝技术的联合方案可视为理想选择。当骨折块严重受损且较小时,基于缝线固定的综合方案可使术后功能恢复更好。