Duan Siyu, Xu Rongda, Liu Hanfei, Sun Ming, Liang Hairui, Cai Zhencun
Department of Orthopedic Surgery, The Second Hospital Affiliated to Shenyang Medical College, Shenyang City, Liaoning Province, China.
Department of Orthopedic Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang City, Liaoning Province, China.
BMC Musculoskelet Disord. 2025 Jan 20;26(1):72. doi: 10.1186/s12891-025-08309-4.
The treatment of comminuted inferior pole patellar fractures has long posed a challenge for orthopedic surgeons. This study aims to compare the biomechanical stability and clinical efficacy of Kirschner wire tension band combined with anchor cross-suture fixation versus traditional partial patellectomy in the treatment of comminuted inferior pole patellar fractures.
A retrospective analysis was conducted on 14 patients who underwent Kirschner wire tension band combined with anchor cross-suture fixation (Group A) in our department of orthopedics from September 2020 to April 2022. Additionally, we matched 14 patients with similar baseline characteristics who received inferior pole patellectomy combined with patellar tendon repair (Group B). The two groups were compared in terms of operative time, intraoperative blood loss, postoperative complications, and at the final follow-up, knee range of motion (ROM), visual analogue scale (VAS) score, Bostman knee function score, peak knee torque, and Insall-Salvati (IS) ratio.
All patients were followed up for more than 12 months. At the final follow-up, Group A showed significantly better outcomes than Group B in terms of knee range of motion (ROM), Bostman knee function score, knee VAS score, and average peak knee torque, with statistically significant differences (P < 0.05), indicating faster postoperative recovery and better clinical results in Group A. The IS ratio of the injured knee in Group B was 0.71 ± 0.66, less than 0.8, suggesting a decrease in patellar height. There were no significant differences between the two groups in terms of operative time, intraoperative blood loss, or incision length (P > 0.05). In Group A, one patient experienced complications from hardware irritation, while in Group B, one patient had postoperative knee pain, and two patients experienced knee extension weakness after cast removal and rehabilitation.
Kirschner wire tension band combined with anchor cross-suture fixation for the treatment of inferior pole patellar fractures yields satisfactory results. This technique provides reliable fixation, restores the original extensor mechanism, promotes early postoperative rehabilitation, and reduces the incidence of complications, making it suitable for clinical application and widespread use.
Level III (retrospective comparative study).
粉碎性髌骨下极骨折的治疗长期以来一直是骨科医生面临的挑战。本研究旨在比较克氏针张力带联合锚钉交叉缝合固定与传统部分髌骨切除术治疗粉碎性髌骨下极骨折的生物力学稳定性和临床疗效。
对2020年9月至2022年4月在我院骨科接受克氏针张力带联合锚钉交叉缝合固定治疗的14例患者（A组）进行回顾性分析。另外，选取14例基线特征相似、接受髌骨下极切除术联合髌腱修复的患者作为对照（B组）。比较两组患者的手术时间、术中出血量、术后并发症，以及末次随访时的膝关节活动度（ROM）、视觉模拟评分（VAS）、Bostman膝关节功能评分、膝关节峰值扭矩和Insall-Salvati（IS）比值。
所有患者均获随访12个月以上。末次随访时，A组患者的膝关节活动度（ROM）、Bostman膝关节功能评分、膝关节VAS评分及平均膝关节峰值扭矩均显著优于B组，差异有统计学意义（P < 0.05），提示A组患者术后恢复更快，临床效果更佳。B组患侧膝关节的IS比值为0.71±0.66，小于0.8，提示髌骨高度降低。两组患者的手术时间、术中出血量及切口长度比较，差异无统计学意义（P > 0.05）。A组有1例患者出现内固定刺激并发症，B组有1例患者术后膝关节疼痛，2例患者拆除石膏及康复后出现膝关节伸直无力。
克氏针张力带联合锚钉交叉缝合固定治疗髌骨下极骨折疗效满意。该技术固定可靠，可恢复原有的伸膝机制，促进术后早期康复，减少并发症的发生，适合临床推广应用。
Ⅲ级（回顾性对比研究）。
