The additional iron cable fixation between proximal patella and tibial tuberosity to treat AO/OTA 34C3 patellar fracture

Mapping Intimacies ◽

10.21203/rs.3.rs-25683/v1 ◽

2020 ◽

Author(s):

Dongzheng Zhang ◽

Yong Shen

Keyword(s):

Statistical Difference ◽

Kirschner Wire ◽

Operation Time ◽

Tibial Tuberosity ◽

Tension Band ◽

Patellar Fracture ◽

Wire Tension ◽

Significant Statistical Difference ◽

Cable Fixation ◽

Additional Iron

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.

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The additional iron cable fixation between proximal patella and tibial tuberosity to treat AO/OTA 34C3 patellar fracture

10.21203/rs.3.rs-25683/v2 ◽

2020 ◽

Author(s):

Dongzheng Zhang ◽

Yong Shen

Keyword(s):

Statistical Difference ◽

Kirschner Wire ◽

Operation Time ◽

Tibial Tuberosity ◽

Tension Band ◽

Patellar Fracture ◽

Wire Tension ◽

Significant Statistical Difference ◽

Cable Fixation ◽

Additional Iron

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.

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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

10.21203/rs.3.rs-1215918/v1 ◽

2022 ◽

Author(s):

chen bingqian ◽

zhengfei wang ◽

zhi chen ◽

xiaohong qu ◽

xiaowen fang ◽

...

Keyword(s):

Internal Fixation ◽

Kirschner Wire ◽

Operation Time ◽

Tension Band ◽

Double Row ◽

Inferior Pole ◽

Wire Tension ◽

Suture Bridge ◽

Suture Bridge Technique ◽

Anchor Suture

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.

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Comparison of the Kirschner Wire Tension Band with a Novel Nickel–Titanium Arched Shape–Memory Alloy Connector in Transverse Patellar Fractures: A Retrospective Study

The Journal of Knee Surgery ◽

10.1055/s-0039-3402802 ◽

2020 ◽

Author(s):

Yang Wang ◽

Demeng Xia ◽

Xi Luo ◽

Hongyue Zhang ◽

Jianghong Wu ◽

...

Keyword(s):

Shape Memory Alloy ◽

Hospital Stay ◽

Shape Memory ◽

Kirschner Wire ◽

Length Of Hospital Stay ◽

Nickel Titanium ◽

Tension Band ◽

Wire Tension ◽

Surgical Duration ◽

Patellar Fractures

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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Stress avulsion of the tibial tuberosity after tension band wiring of a patellar fracture: a case report

Cases Journal ◽

10.1186/1757-1626-2-9357 ◽

2009 ◽

Vol 2 (1) ◽

Cited By ~ 2

Author(s):

Michael T Hirschmann ◽

Björn Wind ◽

Christian Mauch ◽

Gesa Ickler ◽

Niklaus F Friederich

Keyword(s):

Case Report ◽

Tibial Tuberosity ◽

Tension Band ◽

Tension Band Wiring ◽

Patellar Fracture

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Comparative study of surgical treatment of acromioclavicular luxation

Vojnosanitetski pregled ◽

10.2298/vsp1303292k ◽

2013 ◽

Vol 70 (3) ◽

pp. 292-297 ◽

Cited By ~ 4

Author(s):

Miroslav Kezunovic ◽

Dusko Bjelica ◽

Stevo Popovic

Keyword(s):

Statistical Difference ◽

Constant Score ◽

Kirschner Wire ◽

Stage Iv ◽

Hook Plate ◽

Surgical Approaches ◽

Ac Joint ◽

Advantages And Disadvantages ◽

Significant Statistical Difference ◽

Plate Group

Background/Aim. Acromioclavicular (AC) luxations most often affect athletes. The published results regarding the treatment of AC joint luxations vary. Each method has its advantages and disadvantages, so there is still no consensus on the best method of treatment. The aim of this study was to review the results of a number of surgical approaches to stabilization of AC joint recorded over the span of five years. Methods. This study was based on the data acquired from the analysis of 28 patients with AC luxation surgically treated in the Clinical Center of Montenegro. One group of 16 patients underwent the traditional AO method (with transfixation of AC joint with Kirschner wire and Zuggurtung tension bands) or the Bosworth method (using the coracoclaviculartransfixation screw - Zugg-Bosw group). The second group of 12 patients underwent a newer techinque with the Hook plate (Hook plate group). Results. All the patients had AC luxation of higher degree, stage IV-VI acording to the Rockwood scale. The average age of the two groups was very similar, with 28 being the average age of the Zugg-Bosw group, and 25 of the Hook plate group. Most patients were males (82%), injured mostly during athletic activity (75%-83%). Complications were more common and more complex in the Zugg-Bosw group, with 2 early and 8 late comlications. There are only 3 late complications in the Hook plate group, but with no significant statistical difference (p = 0.19; t = -1.34; df = 27). With respect to the subjective patient satisfaction following the treatment, the Hook plate group gave significantly better evaluations (4.4 ? 0.19)(p = 0.007; t = 2.95; df = 27). Constant score showed no significant statistical difference (p = 0.078; t = 1.8; df = 27). The Hook plate group had a better median score (90 ? 0.18) with respect to the Zugg-Bosw group (85 ? 0.40). Conclusion. The Hook plate method achieved somewhat better results, which indicate that this method is one of the ways to ensure a strong, stable fixation of the AC joint without transfixation. At the same time, this method does not inhibit the ligament healing and allows an early mobilisation.

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Efficacy and Safety Evaluation of Transurethral Resection of the Prostate versus Plasmakinetic Enucleation of the Prostate in the Treatment of Massive Benign Prostatic Hyperplasia

Urologia Internationalis ◽

10.1159/000511116 ◽

2021 ◽

pp. 1-8

Author(s):

Jian Zhang ◽

Yonghui Wang ◽

Shuang Li ◽

Shipeng Jin ◽

Shiqing Zhang ◽

...

Keyword(s):

Benign Prostatic Hyperplasia ◽

Clinical Efficacy ◽

Transurethral Resection ◽

Statistical Difference ◽

Operation Time ◽

Hemoglobin Concentration ◽

Prostatic Hyperplasia ◽

Urinary Flow ◽

Significant Statistical Difference ◽

Aging Men

Background: Benign prostatic hyperplasia (BPH) is a common chronic progressive disease resulting in urinary obstruction in aging men. It comes to more and more patients with massive BPH with the aging of society and extension of life expectancy. Objective: The aim of the study was to compare the clinical efficacy, safety, and complications between transurethral bipolar plasmakinetic enucleation of the prostate (PKEP) and transurethral resection of the prostate (TURP) in the treatment of massive BPH. Design and Setting: Patients with BPH were divided into the PKEP group and the TURP group randomly. Intraoperative blood loss (BL), operation time (OT), resected tissue weight (RTW), gland resection ratio (GRR), postoperative indwelling ureter time (IUT), bladder fistula time (BFT) and hospital stay time (HST), preoperative and postoperative serum sodium concentration (SSC), hemoglobin concentration (HGB), prostate weight (PW), postvoid residual (PVR), maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), quality of life (QOL), International Index of Erectile Function (IIEF), and other complications were analyzed and compared respectively. Results: There was no statistical difference in preoperative IPSS, preoperative QOL score, preoperative PVR, preoperative Qmax, postoperative QOL score, postoperative PVR, postoperative Qmax, IPSS difference value (DV), Qmax DV, and PVR DV between the PKEP group and the TURP group (p > 0.05). OT, BL, IUT, BFT, HST, and postoperative IPSS in the PKEP group were significantly lower than that in the TURP group (p < 0.01). RTW and GRR in the PKEP group were significantly higher than that in the TURP group (p < 0.01). QOL DV in the PKEP group was higher than that in the TURP group (p < 0.05). There was statistical difference in SSC DV between the PKEP group and the TURP group (p < 0.05). There was significant statistical difference in postoperative PW, postoperative HGB, PW DV, and HGB DV between the PKEP group and the TURP group (p < 0.01). There was significant statistical difference in IPSS, QOL, PVR, and Qmax between postoperative value and preoperative value in both groups (p < 0.01). The incidence of transurethral resection syndrome, obturator nerve reflex, transient urinary incontinence, and retrograde ejaculation between the PKEP group and the TURP group has no statistical difference (p > 0.05). Capsule perforation, blood transfusion, secondary hemorrhage, bladder neck contracture, and urethral stricture in the PKEP group were lower than that in the TURP group (p < 0.05). Bladder spasm in the PKEP group was significantly lower than that in the TURP group (p < 0.01). There was no statistical difference in preoperative and postoperative IIEF-5, effective erectile frequency, telotism average tension, sustainable telotism average time, and sexual dissatisfaction between the PKEP group and the TURP group (p > 0.05). Conclusions: PKEP and TURP have similar clinical efficacy in the treatment of massive BPH. PKEP has advantages in shorter OT, less BL, more GRR, and fewer complications, but the long-term therapeutic effect of PKEP needs further follow-up.

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