Prasanna Arul, Arasu Arul Durai
Department of Orthopaedics, JJ Arul Hospital, 2/1A2 , Dindigul - Madurai NH, Dindigul, Tamil Nadu, India.
J Orthop Case Rep. 2024 Oct;14(10):255-262. doi: 10.13107/jocr.2024.v14.i10.4882.
Comminuted patella fractures pose a challenge to orthopaedic surgeons , since tension band wiring and cerclage is not effective and often lead to loosening of wires, hardware problem, dislocation of fracture and failure of osteosynthesis resulting in post-traumatic osteoarthritis and knee stiffness. The aim of this study is to evaluate the clinical outcome in patients with AO 34C2 and 34C3 highly comminuted patella fractures treated with unidirectional fixed angle titanium patella locking plate.
Twelve patients who presented with AO 34C2 and 34C3 comminuted patella fractures, aged between 18-79 years were included in the study. All fractures were reduced and fixed with unidirectional angle fixed stable titanium patella locking plate. Knee range of motion and knee outcome survey activities of daily living scale (KOS-ADL) was used to evaluate the outcome.
Union of fracture was achieved in all twelve patients. Mean flexion at final follow-up was 123° (110°-130°). None of the patients had extensor lag. One patient had hardware irritation which resolved at final followup.
This technique serves as an effective option in highly comminuted patella fractures by providing excellent mechanical stability resulting in anatomical reduction , excellent functional outcome , lower incidence of hardware irritation or failure of osteosynthesis.
粉碎性髌骨骨折给骨科医生带来了挑战,因为张力带钢丝固定和环扎术效果不佳,且常导致钢丝松动、内固定问题、骨折脱位以及骨合成失败,进而引发创伤后骨关节炎和膝关节僵硬。本研究的目的是评估采用单向固定角度钛髌骨锁定钢板治疗AO 34C2和34C3型高度粉碎性髌骨骨折患者的临床疗效。
本研究纳入了12例年龄在18至79岁之间、患有AO 34C2和34C3型粉碎性髌骨骨折的患者。所有骨折均采用单向角度固定稳定钛髌骨锁定钢板进行复位和固定。采用膝关节活动范围和膝关节功能结果调查日常生活量表(KOS-ADL)来评估疗效。
12例患者均实现了骨折愈合。末次随访时的平均屈曲角度为123°(110°-130°)。所有患者均无伸膝滞后。1例患者出现内固定刺激,在末次随访时症状消失。
该技术通过提供优异的机械稳定性,实现解剖复位,获得良好的功能结果,降低内固定刺激或骨合成失败的发生率,是治疗高度粉碎性髌骨骨折的有效选择。