Department of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University School of Medicine, Goyang-si 10380, Republic of Korea.
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Medicina (Kaunas). 2024 May 9;60(5):789. doi: 10.3390/medicina60050789.
Patella baja is a common complication after operative treatment for patellar fracture. This study aimed to investigate (1) the serial changes in patellar height and (2) the potential predictive factors for patellar height changes after tension band wiring (TBW) for patellar fractures. Forty-one patients who underwent TBW for patellar fracture between March 2019 and September 2022 were enrolled. To identify serial changes in patellar height, modified Blackburne-Peel index (mBPI) was assessed at just after surgery, at 3 months, at 6 months, at 1 year and at the final follow-up. Multiple regression analysis was conducted to identify factors correlated with mBPI difference between the contralateral side (considered as preoperative status) and injured side. The postoperative mBPI exhibited a decline over time (mean mBPI immediately post operation/3 months/6 months/1 year/final follow-up: 0.69/0.63/0.63/0.62/0.61) Specifically, mBPI showed a significant reduction immediately post operation to 3 months ( < 0.001), although comparisons at other time points did not reveal significant differences. A lower position of the fracture was associated with a decrease in patellar height after surgery. Patellar height was mainly decreased from immediately post operation to 3 months. A fracture in a lower position of associated with decreased patellar height after the TBW of the transverse patellar fracture.
髌骨低位是髌骨骨折手术后的常见并发症。本研究旨在探讨:(1)髌骨高度的连续变化;(2)经张力带钢丝固定(TBW)治疗髌骨骨折后髌骨高度变化的潜在预测因素。2019 年 3 月至 2022 年 9 月期间,共有 41 例髌骨骨折患者接受 TBW 治疗。为了确定髌骨高度的连续变化,在术后即刻、3 个月、6 个月、1 年和最终随访时评估改良 Blackburne-Peel 指数(mBPI)。采用多元回归分析确定与健侧(视为术前状态)和患侧 mBPI 差值相关的因素。术后 mBPI 随时间呈下降趋势(术后即刻/mBPI3 个月/mBPI6 个月/mBPI1 年/mBPI 最终随访:0.69/0.63/0.63/0.62/0.61)。具体而言,mBPI 术后即刻至 3 个月显著降低(<0.001),尽管其他时间点的比较无显著差异。骨折位置较低与术后髌骨高度降低有关。髌骨高度主要在术后即刻至 3 个月期间降低。TBW 治疗横断髌骨骨折后,骨折位置较低与髌骨高度降低有关。