Comparison And Analysis Of Clinical Effects Between The Tension Band Of Kirschner Wire And Absorbable Material Fixation In The Treatment Of The Patella Fractures

Objective: To summarize the advantages and disadvantages of Kirschner wire tension band group and absorbable wire fixation group in the treatment of patellar type C fracture,and to guide clinical application.Methods: A retrospective analysis was conducted to select 129 eligible patellar fracture patients from Wendeng Orthopaedic Hospital of Shandong Province from September 2012 to February 2017.A total of 129 cases met the inclusion criteria and no exclusion criteria.There were 64 females and 65 males.The youngest was 19 years old,the oldest was 55 years old,and the average age was 35.95 years old.According to AO classification,the A type of fracture were extraarticular fracture,B type were intra-articular longitudinal fracture and C type were complete intra-articular transverse fracture.The fracture of patients we selected were all type C.Among them,57 cases were treated with absorbable line fixation(group A),32 cases were on the left side,25 cases were on the right side.The tension band of Kirschner wire(group B)consisted of 72 cases,40 cases on the left side and 32 cases on the right side.Statistical analysis was carried out to evaluate the advantages and disadvantages of the two methods.Results: All patients were followed up,the follow-up rate was about 100%,3 months to 12 months,with an average of 8.5 months.No incision infection occurred during the follow-up period in both groups.The incision length was 8.74 ±1.37 cm in group A,9.33 ±1.43 cm in group B,and 88.42 ±19.29 min in group A and 94.66 ±21.69 m in group B.The operation time was 88.42 ±19.29 min in group A and 94.66 ±21.69 m in group B.Intraoperative bleeding volume: 50.52±5.74 ml in group A,50.705±17 ml in group B;fracture healing time;13.58±1.22 weeks,B 13.89±1.42 weeks in group A;joint function: 95% in group A,96% in group B;one month biomechanics after operation: 43.53±0.18 in group A,1.89±0.18 in group B.Kirschner wire cable tension band 1.83±0.20;three months biomechanics after operation: group A absorbable wire group 1.92±0.23,group B Kirschner wire tension band 1.86±0.25;six months biomechanics after operation: group A 1.95±0.31,group B 1.91±0.42 respectively.All the above indexes were followed up regularly.There was no significant difference(P > 0.05).In terms of postoperative complications,there were 2 cases in group A and 11 cases in group B.The incidence of complications in group A was about 3.5%,which was significantly lower than 15.3% in group B(P < 0.05).Conclusion: Both Kirschner wire tension band and absorbable line can play a good role in the treatment of patellar fracture,but absorbable wire fixation has fewer complications than Kirschner wire tension band.It is economical and practical,and has good tissue compatibility,but soft tissue irritation,and does not need to be removed by second operation.It is suitable for popularization.