Department of Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy.
Department of Orthopedic and Traumatology (DICHIRONS), University of Palermo, Via del Vespro, 129, 90127, Palermo, Italy.
Eur J Orthop Surg Traumatol. 2024 May;34(4):2065-2071. doi: 10.1007/s00590-024-03887-w. Epub 2024 Mar 26.
Traditionally, patellar fractures (PFs) have been managed using metallic tension band fixation, a method often associated with a notable rate of complications. Considering these challenges, this study explores the potential of nonmetallic fixation as a treatment option for PFs. This research aims to provide robust evidence supporting the use of the nonmetallic tension band fixation technique as an effective alternative to conventional metallic tension band fixation, thereby advancing the standard of care in treating these fractures.
This retrospective study analyzed a consecutive patient series presenting with PFs from 2008 to 2021, treated with a nonmetallic tension band fixation technique. Inclusion criteria were strictly defined to include individuals over 18 years of age with isolated PFs requiring surgical intervention. The study focused on evaluating postoperative complications and clinical outcomes, as measured by standardized scoring systems, at the final follow-up point to assess the efficacy and safety of the employed surgical technique.
In this study, with a mean follow-up of 64 ± 7 months, a total of 64 patients who received open reduction and internal fixation (ORIF) for PFs were enrolled. Among these, five cases required additional surgical interventions. Specifically, two cases were due to knee stiffness, while the remaining three involved complications such as superficial infection, skin irritation, or delayed wound healing. The mean postoperative values recorded for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Oxford knee score (OKS), and visual analog scale (VAS) were 20.4 ± 2.3, 35.5 ± 5.3, and 1.6 ± 0.4, respectively. There were no complications related to the nonmetallic fixation technique or instances of loss of reduction.
This study substantiates that nonmetallic tension band fixation is a safe and effective alternative to traditional metallic tension band fixation for patellar fractures. The study's low-complication rate and reoperation frequency underscore the value of nonmetallic implants in mitigating adverse effects and enhancing clinical outcomes.
IV.
传统上，髌骨骨折（PFs）采用金属张力带固定治疗，该方法常伴有较高的并发症发生率。鉴于这些挑战，本研究探讨了非金属固定作为 PF 治疗选择的潜力。本研究旨在提供强有力的证据支持使用非金属张力带固定技术作为传统金属张力带固定的有效替代方法，从而提高治疗这些骨折的护理标准。
本回顾性研究分析了 2008 年至 2021 年期间连续就诊的、采用非金属张力带固定技术治疗的髌骨骨折患者系列。纳入标准严格定义为年龄大于 18 岁、需要手术干预的单纯髌骨骨折患者。研究重点是评估术后并发症和临床结局，使用标准化评分系统在最终随访点进行评估，以评估所采用手术技术的疗效和安全性。
在这项研究中，平均随访 64±7 个月，共纳入 64 例接受髌骨切开复位内固定术（ORIF）治疗的髌骨骨折患者。其中 5 例需要额外的手术干预。具体来说，2 例是由于膝关节僵硬，而其余 3 例涉及浅表感染、皮肤刺激或延迟伤口愈合等并发症。记录的术后 Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）评分、Oxford knee score（OKS）和视觉模拟评分（VAS）的平均值分别为 20.4±2.3、35.5±5.3 和 1.6±0.4。非金属固定技术无并发症，也无复位丢失。
本研究证实，非金属张力带固定是传统金属张力带固定治疗髌骨骨折的一种安全有效的替代方法。该研究低并发症率和再手术率突出了非金属植入物在减轻不良反应和改善临床结局方面的价值。
IV。
