scholarly journals Clinical Comparative Study on the Treatment of Inferior Pole Fractures of Patella by Double-row Anchor Suture Bridge Technique Combined with Kirschner Wire Tension Band Internal Fixation

Author(s):  
chen bingqian ◽  
zhengfei wang ◽  
zhi chen ◽  
xiaohong qu ◽  
xiaowen fang ◽  
...  

Abstract Objective: To investigate the method, technique and clinical efficacy of double-row anchor suture bridge technique in the treatment of inferior pole fractures of patella, and to compare it with traditional Kirschner wire tension band internal fixation. Methods: General information A total of 62 patients were enrolled in this study, including 35 males and 27 females, aged 31-80 years old, with an average of (53.2±4) years old. All the patients were divided into two groups by a random double-blind method: Group A (double-row anchor suture bridge technique group) and Group B (Kirschner wire tension band internal fixation group), with 32 cases and 30 cases in each group, respectively. The two techniques were performed by the same group of doctors to fix the fracture respectively, and the intraoperative bleeding, operation time, incidence of postoperative complications, knee function score, etc., were compared between the two techniques. Results: Group A (double-row anchor suture bridge technique group): operation time 56-80min, with an average of (60±10) min; intraoperative blood loss 30-56ml, with an average of (43±10) ml. All incisions healed in one stage and stitches were removed after 2 weeks. No complications such as incision infection, flap necrosis and nerve injury occurred. The average healing time of the fracture was 12 weeks. At the last follow-up, the Bostman score was (28.5±3.3), and the excellent rate was 93.7%. Group B (Kirschner wire tension band internal fixation group): operation time 54-76min, with an average of (56±10) min; intraoperative blood loss 31-50ml, with an average of (43±80) ml. One patient developed delayed incision healing postoperatively. Four patients experienced Kirschner wire withdrawal, one of which was accompanied by infection. Two patients were found to have mild separation of distal fracture fragments, despite the fracture being fine. The average healing time of the fracture was 13 weeks. At the last follow-up, the Bostman score was (23.5±3.3), and the excellent rate was 86.7%. Conclusion: Double-row anchor suture bridge technique is applied to inferior pole fractures of patella by virtue of its various effects, such as the complete preservation of the inferior pole fragments during the operation, satisfactory fracture reduction, firm fixation, and meeting patients’ requirements for early postoperative ambulation. This technology is superior to traditional Kirschner wire tension band internal fixation owing to its advantages of no need to take out the internal fixation, firm fixation, no need to worry about Kirschner wire withdrawal and fewer complications, and its clinical efficacy satisfaction rate is also better than traditional surgical methods. In short, double-row anchor suture bridge technique is an ideal surgical procedure for the treatment of the inferior pole fracture of patella with safety, reliability and high satisfaction.

2020 ◽  
Author(s):  
Dongzheng Zhang ◽  
Yong Shen

Abstract Background: It is very difficult to deal with AO/OTA 34C3 patellar fracture. Although the modified Kirschner wire tension band, the cerclage and plate has been proposed to treat it, the result is not very good. We found that if the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been carried out, the additional iron cable fixation between proximal patella and tibial tuberosity could resolve it effectively.Methods: Retrospective analysis was completed. 21 patients with AO/OTA 34C3 patellar fracture were treated in our department from January 2014 to January 2018. They were divided into 2 groups according to the operation plan. Group 1 (normal group), with 12 patients, was treated with modified Kirschner wire tension band with or without cerclage cable. Group 2 (cable group), with 9 patients, was treated with the additional iron cable fixation between proximal patella and tibial tuberosity when the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been completed.Results: The two groups of the age, sex ratio, trauma mechanism, operation time, free articular fragment, comorbidity and follow-up time had no significant statistical difference (P>0.05). There was no significant statistical difference between the two groups of the clinical results. (such as Bostman total score and its specific individual score, the excellent and good ratio, the complications, and the bone union time, etc.) (P>0.05).Conclusions: To deal with AO/OTA 34C3 patellar fracture, when the fixation of modified Kirschner wire tension band with or without the cerclage cable is not firm enough, the additional iron cable fixation between proximal patella and tibial tuberosity can resolve it effectively.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yupeng Chu ◽  
Ting Hu ◽  
Mangmang Chen ◽  
Chendi Jiang ◽  
Zhuqi Wu ◽  
...  

Abstract Background Tibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults. However, the incidence of such fractures is increasing in adults, concurrent with an increase in sports injuries and traffic accidents. This study describes the fixation-based double-row anchor suture-bridge technique, a novel technique for treating tibial intercondylar eminence fractures in adults; and evaluates its preliminary clinical outcomes. Methods A retrospective evaluation of adult patients with tibial intercondylar eminence fractures treated at our institution from June 2016 to June 2018 was conducted. Seven such patients, treated with the anchor suture-bridge technique, were included. All patients were assessed for knee joint range of motion (ROM), Lysholm knee score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form score, Tegner activity score pre-surgery, and the healing of the fracture at 3, 6 and 12 months minimal post-surgery follow-up. Results Patients were followed for a mean of 12.43 months (range 9-15 months). By the final follow-up, all fractures had fully healed. The mean Lysholm score improved from 27.86 (range, 2 to 54) pre-surgery to 88.14 (range, 81 to 100) 3 months post-surgery (p < 0.05). Similarly, the mean IKDC score improved from 48.86 (range, 43 to 55) to 84.29 (range, 75 to 90) (P < 0.05); and the mean Tegner activity score improved from 1.71 (range, 0 to 4) to 3.29 (range, 2 to 4) (p < 0.05). Furthermore, knee joint ROM, Lysholm scores, IKDC scores, and Tegner activity scores displayed excellent outcomes at the 6 and 12 months minimal follow-up. Conclusion The arthroscopic anchor suture-bridge technique is a valid and secure method for achieving effective fixation of tibial intercondylar eminence fractures in adults.


2020 ◽  
Author(s):  
Dongzheng Zhang ◽  
Yong Shen

Abstract Background:It is very difficult to deal with AO/OTA 34C3 patellar fracture. Although the modified Kirschner wire tension band, the cerclage and plate has been proposed to treat it, the result is not very good. We found that if the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been carried out, the additional iron cable fixation between proximal patella and tibial tuberosity could resolve it effectively.Methods:Retrospective analysis was completed. 21 patients with AO/OTA 34C3 patellar fracture were treated in our department from January 2014 to January 2018. They were divided into 2 groups according to the operation plan. Group 1 (normal group), with 12 patients, was treated with modified Kirschner wire tension band with or without cerclage cable. Group 2 (cable group), with 9 patients, was treated with the additional iron cable fixation between proximal patella and tibial tuberosity when the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been completed.Results:The two groups of the age, sex ratio, trauma mechanism, operation time, free articular fragment, comorbidity and follow-up time had no significant statistical difference (P>0.05). There was no significant statistical difference between the two groups of the clinical results. (such as Bostman total score and its specific individual score, the excellent and good ratio, the complications, and the bone union time, etc.) (P>0.05).Conclusions:To deal with AO/OTA 34C3 patellar fracture, when the fixation of modified Kirschner wire tension band with or without the cerclage cable is not firm enough, the additional iron cable fixation between proximal patella and tibial tuberosity can resolve it effectively.


Medicine ◽  
2019 ◽  
Vol 98 (20) ◽  
pp. e15640 ◽  
Author(s):  
Yi-Ming Ren ◽  
Hong-Bin Zhang ◽  
Yuan-Hui Duan ◽  
Yun-Bo Sun ◽  
Tao Yang ◽  
...  

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 209-211
Author(s):  
Kentaro Watanabe

Five cases with an avulsion fracture of the thumb metacarpophalangeal joint treated by a simple method of internal fixation are described. This method is designed as a form of modified tension band wiring using the combination of a single Kirschner wire and a pull-out wire, and is technically easy.


Author(s):  
Yang Wang ◽  
Demeng Xia ◽  
Xi Luo ◽  
Hongyue Zhang ◽  
Jianghong Wu ◽  
...  

AbstractThis study aims to compare the clinical outcomes of the nickel–titanium arched shape–memory alloy connector (hereafter referred to as the ASC) and tension band fixation for the treatment of transverse patellar fractures. We retrospectively analyzed a total of 257 patients with transverse patellar fractures who were treated at our emergency orthopaedics department from March 2010 to March 2017. Either an ASC or the Kirschner wire (K-wire) tension band had been used to treat these fractures according to surgeons' experience and preference. We compared operative details, postoperative recovery, and postoperative knee function at 6 months. In terms of surgical duration, blood loss, incision length, length of hospital stay, and postoperative complications, patients in the ASC group showed significantly better results than patients in the K-wire group (p < 0.05). There were no significant differences between the two groups in terms of fracture healing time, knee mobility, and the Boström score at the postoperative 6-month evaluation (p > 0.05). Though, there were similar functional outcomes between two groups whose transverse patellar fractures were different methods, we found that the ASC method was a more reliable, more minimally invasive, and safer treatment option than the tension band wiring method using K-wires, resulting in less tissue damage, shorter surgical duration, shorter length of hospital stay, and fewer complications.


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