Archutowski Jacob, Juma Saif, Searls William C, Roderique Tyson, Pampati Vinay
Henry Ford Macomb Hospital, Clinton Twp, MI.
College of Osteopathic Medicine Michigan State University, East Lansing, MI.
Spartan Med Res J. 2025 Aug 7;10(1):30-36. doi: 10.51894/001c.141751. eCollection 2025.
There is a high rate of surgical complications and removal of symptomatic hardware for patients who have undergone open reduction internal fixation (ORIF) for transverse patella fractures. In recent years there has been increased interest in more low profile ORIF techniques to combat these issues. The aim of this study was to evaluate if a reduced hardware burden would correlate with fewer complications and equal rates of fracture union when compared to traditional techniques for treating transverse patella fractures.
Nine patient charts were retrospectively reviewed dating between June 2015 and March 2023. All patients sustained a transverse patella fracture and underwent ORIF with a suture button and suture tension band construct by a single surgeon. The primary outcome measure was rate of radiographic fracture union at final follow up. Secondary outcome measures included any need for removal of hardware or other revision procedure, surgical and medical complications, postoperative pain score and the ability to perform a straight leg raise.
Eight of nine patients demonstrated radiographic evidence of fracture consolidation with an average follow-up time of 17.9 months (range 12-26 months). One patient required an additional operation for revision ORIF before going on to successful union. No patients underwent a procedure for removal of hardware before final follow up. All patients were able to hold a straight leg raise at final follow up.
Suture button with suture tension band construct is a reasonable treatment option for treating transverse patella fractures. Surgeons may employ this technique for older patients or those with some fracture comminution, although there should be some caution and close follow up for displacement.
对于接受切开复位内固定术（ORIF）治疗横形髌骨骨折的患者，手术并发症发生率较高，且常需取出引起症状的内固定物。近年来，人们越来越关注采用更微创的ORIF技术来解决这些问题。本研究的目的是评估与治疗横形髌骨骨折的传统技术相比，减少内固定物负荷是否与更少的并发症以及相同的骨折愈合率相关。
回顾性分析了2015年6月至2023年3月期间的9例患者病历。所有患者均为横形髌骨骨折，并由同一位外科医生采用缝线纽扣和缝线张力带结构进行ORIF。主要观察指标是末次随访时影像学骨折愈合率。次要观察指标包括是否需要取出内固定物或进行其他翻修手术、手术和医疗并发症、术后疼痛评分以及直腿抬高能力。
9例患者中有8例在平均17.9个月（范围12 - 26个月）的随访时显示有骨折愈合的影像学证据。1例患者在继续成功愈合之前需要额外进行一次ORIF翻修手术。在末次随访前，没有患者接受内固定物取出手术。所有患者在末次随访时都能够进行直腿抬高。
缝线纽扣和缝线张力带结构是治疗横形髌骨骨折的一种合理治疗选择。外科医生可以将此技术用于老年患者或有一定骨折粉碎的患者，尽管对于移位情况应谨慎并密切随访。
