Clinical Observation On The Treatment Of Patella Fracture With Patella Claw And Tension Band

PurposeThe aim of this study was a retrospective analysis of the adults of the displaced fractures of the patella that received the surgical treatment by open reduction and internal fixation with modified anterior tension band or memory alloy patella claw of clinical curative effect of observation, and analyses the clinical curative effect of two groups of patients, points out that the two methods of surgical treatment for treating this type of fracture the advantages and disadvantages of both and provide reference for clinical treatment of displaced patella fracture.Methods1. Case collection:the study of all the data are in February 2014 to January 2015, department of orthopedics ward of Chengdu University of Traditional Chinese Medicine affiliated hospital, a total of 60 cases with complete information collection.2. Group:Collection of 30 patients from using memory alloy patella claw as internal fixation, the rest of the 30 patients from using modified anterior tension band as internal fixation, all patients were corresponding functional exercise, evaluation of patients with postoperative 1 week,2 weeks.1 month,3 months,6 months, and year after fracture treatment curative effect.3. Observation indexes:Compare two groups of patients in operation time, the rate of the complications after the operation.the range of flexion and extension of the knee joint after operation at 1 week,2 week,l month,3 months, the fracture healing time of both groups, the VAS score4. of two groups of patients at 1 week,2 weeks,1 month, and the Bostman score system of two groups of patients at 3 month,6 months,1 year.Results1. Baseline comparison of two groups of patients:the two groups of patients with gender, age. classification, and cause of injury, analysis of the results, not significant, comparable.2. After treatment results of analysis:In the two groups of patients in the operation time of the comparison, patella claw fixation group consumption time was significantly less than that of the wire tension band fixation group, and the difference between the two groups was statistically significant.3. After 1 and 2 weeks of knee flexion range of motion recover) of contrast, patella in fixation group was better than that of Kirschner wire tension band group and differences between the two groups of patients has statistical significance; comparison of postoperative 1 week.2 week extension knee range of motion recovery and postoperative 1 month.3 months knee range of motion recovery, between the two groups of patients, although differences, but differences between the groups does not have statistical significance.4.1 weeks, weeks,2 weeks, January VAS pain score and final fracture healing time in two groups of patients were compared, although there were differences between the two groups, but the difference was not statistically significant.5. At 3 months,6 months and 1 year after surgery in patients with bostman patellar fracture clinical curative effect evaluation of contrast, patella fixation group was better than that of Kirschner wire tension band fixation group, but the difference between the two groups does not have statistical significance.6. During the 1 year follow-up period, there was no significant difference in the incidence of postoperative complications between the two groups.ConclusionSelection of patella was used as an internal fixtures and the as internal fixation for the treatment of adult displaced patellar fractures with Kirschner wire and tension is, for simple patellar transverse fractures (AO type C1) patients, these two kinds of internal fixation for this type of fracture are better treatment method and clinical can get satisfactory effect. But for comminuted patella fracture, fracture block volume is larger, the fracture type of fracture in block number is small (AO type C2 and C3.1), two kinds of internal fixation and their respective strengths and weaknesses:the patella as internal fixator relatively operation time is short, early knee function recovery complex is better. And the Kirschner wire and tension band fixation time is longer, early knee function recovery is acceptable, but the treatment cost is relatively low. Altogether:the AO classification, type C1 fracture of patella, two kinds of internal fixation devices are better methods; for AO type C2 and C3.I type fracture of patella, choose patella claw as internal fixation can consume less operation time to complete fracture reduction and fixed, and to obtain better early knee flexion activity recovery and a Kirschner wire tension with certain advantages. The fracture healing time and the recovery of the knee joint function of the two groups were satisfactory.