Solunkhe Swaroop, Shah Meet, Patil Vishal, Kuity Kaman
Department of Orthopaedics, Dr. D.Y. Patil Medical College Hospital and Research Institute, Pimpri-Chinchwad, Maharashtra, India.
J Orthop Case Rep. 2024 Oct;14(10):230-235. doi: 10.13107/jocr.2024.v14.i10.4874.
The inferior pole of patella constitutes around 9.3-22% of all the patella fractures presenting to the hospital. The management of inferior pole fractures has been debated since a long from early day of partial or full patellectomy to the current dictum of open reduction and fixation because of the importance of extensor mechanism of the knee. There are various modalities of management of the inferior pole of patella fracture. The use of braided polyester wire has shown to have a higher load to failure and less implant fatigue, leading to the use of trams osseous repair technique with fiber wire as an alternative to tension ban wiring.
Twenty patients were divided into two groups of 10 each: Group A comprised of patients operated with tension band wiring (TBW) and Group B with patient operated with transosseous repair. Both groups underwent the same physiotherapy postoperatively and the results were compared.
Radiological outcomes and the WOMAC score of the patients are comparable in both groups. The return to full range of motion is also similar in both groups with similar physiotherapy given in both groups.
This shows that with careful patient selection transosseous repair can be used as an alternative to TBW.
髌骨下极骨折占医院收治的所有髌骨骨折的9.3%-22%左右。由于膝关节伸肌机制的重要性，从早期的部分或全髌骨切除术到目前的切开复位内固定原则，髌骨下极骨折的治疗一直备受争议。髌骨下极骨折有多种治疗方式。编织聚酯线已显示出更高的破坏载荷和更低的植入物疲劳性，从而导致采用带纤维线的经骨修复技术作为张力带钢丝固定的替代方法。
20例患者分为两组，每组10例：A组采用张力带钢丝固定（TBW）手术治疗，B组采用经骨修复手术治疗。两组术后均接受相同的物理治疗，并比较结果。
两组患者的影像学结果和WOMAC评分相当。两组在接受相似物理治疗的情况下，恢复到全关节活动范围的情况也相似。
这表明，经过仔细的患者选择，经骨修复可作为张力带钢丝固定的替代方法。
