Smith S T, Cramer K E, Karges D E, Watson J T, Moed B R
Department of Orthopaedics, Henry Ford Hospital, Detroit, MI 48202, USA.
J Orthop Trauma. 1997 Apr;11(3):183-7. doi: 10.1097/00005131-199704000-00008.
To identify and review early complications in the operative treatment of patella fractures.
Retrospective review.
Single tertiary care institution with multiple surgeons, including generalists and fellowship trained subspecialists.
A consecutive series of eighty-seven patella fractures over a five year period was reviewed. Patients treated nonoperatively or with partial or total patellectomy were excluded. Minimum follow-up to fracture healing (four months) was available in fifty-one fractures.
Modified tension band wire fixation was used in forty-nine fractures, whereas two fractures were treated with tension band wires threaded through cannulated screws.
Early complications such as loss of reduction or fixation, infection, or soft-tissue problems were evaluated.
Displacement of > or = 2 mm before healing was noted in eleven fractures. The displacement could be attributed to technical errors in five cases, and to patient noncompliance with postoperative activity restrictions in another five cases. Two cases of superficial infection were documented. Nine patients with symptomatic hardware required hardware removal.
Twenty-two percent of fractures treated with tension band wiring and early motion displaced > or = 2 mm within the early postoperative period. Technical errors or patient noncompliance were identified as factors. The incidence of early complications in operatively treated patella fractures is higher than previously reported.
识别并回顾髌骨骨折手术治疗中的早期并发症。
回顾性研究。
一家拥有多名外科医生的三级医疗机构，包括普通外科医生和经过专科培训的亚专科医生。
回顾了连续五年内的87例髌骨骨折病例。排除接受非手术治疗或部分或全髌骨切除术的患者。51例骨折患者获得了至少至骨折愈合（四个月）的随访。
49例骨折采用改良张力带钢丝固定，2例骨折采用穿过空心螺钉的张力带钢丝治疗。
评估早期并发症，如复位或固定丢失、感染或软组织问题。
11例骨折在愈合前出现≥2mm的移位。其中5例移位可归因于技术失误，另外5例归因于患者未遵守术后活动限制。记录到2例浅表感染。9例有症状的内固定患者需要取出内固定。
采用张力带钢丝固定并早期活动治疗的骨折中，22%在术后早期出现≥2mm的移位。技术失误或患者不依从被确定为相关因素。手术治疗髌骨骨折的早期并发症发生率高于先前报道。
