| Objective: To compare the curative effect of seven internal fixation methods and make theoretical analysis to offer basis on choosing the proper treatment method in clinic.Methods: From June 1999 to June 2006, We retrospective reviewed the clinical and radiological records of 359 patients treated by seven internal fixation methods: silk circular suture 35cases; iron circular wire 29cases; Magnuson iron wire 41cases; AO tension belt 87cases; improved AO tension belt 92cases; Ti′s patellar catching 70cases ; Kirschner′s pins steel wire tension belt united Ti′s patellar catching 5cases. Al1 these patients were followed-up for 10 months to 6 years with an average of 32 months. To compare and analysis the curative effects on patella fracture with several kinds of different internal fixations from those as follows: The short-term curative effect ( the anatomic repositon rate and fracture displaces on postoperation X-ray), the average recovering time, and the long-term curative effect( the functionalevaluation of the knee joint )Results : The short-term curative effect and the average recovering time:The improved AO tension belt and AO tension belt are better than the others in treating patellar transverse fractures;The Ti′s patellar catching and Kirschner′s pins steel wire tension belt united Ti′s patellar catching are better than the others in treating communited patellar fractures. the long-term curative effect: The improved AO tension belt and AO tension belt are better than the others in treating patellar transverse fractures;The Ti′s patellar catching and Kirschner′s pins steel wire tension belt united Ti′s patellar catching are better than the others in treating communited patellar fracturesConclusion: There are many kinds of internal fixations in treating patellar fradture nowadays.The surgonal method that we chose is suitable or not can impact the knee′s recovering directly.therefor,we should choose defferent internal fixation methods according different types of patellar fractures to make the knee′s mechanic continusly and the articular surface smoothnessed as soon as possible,the perfect internal fixation is helpful to the knee′s early activity,so that recover the patellar′s function as possible.Through comparing several kinds of internal fixations,wocan conclude as follows:①silk circular suture iron circular wire and Magnuson iron wire are not suitable to choose singly because of their not enough fixational sthength, but they can be united with AO tension belt or patellar catching as a good method for treating the patellar comminuted fracture.②The improved AO tension belt and AO tension belt are better than the other in the short-term curative effect, the average recovering time and the long-term curative effect,which should be regarded as the regular and first choice in treating patellar transverse fracture.③Ti′s patellar catching is considered as the best method in treating the patellar communited fracture because of being better than the other in the short-term curative effect, the average recovering time and the long-term curative effect.④Kirschner′s pins steel wire tension belt united Ti′s patellar catching is effective and reliable for serious communited patellar fracture... |
