Clinical Study On The Treatment For Fractures Of Inferior Patellar By Kirschner Wire And Tension Band Fixation And Suturing

Objective: To explore the clinical efficacy of Kirschner wire and tension band fixation and suturing for fractures of inferior patellar.Methods: Patients with fractures of inferior patellar who were admitted into the First Affiliated Hospital of Fujian Medical University from June 2012 to June 2018 were collected and analyzed retrospectively.According to the selection criteria,a total of 46 patients with fractures of inferior patellar were enrolled,including 19 males and 27 females,with a mean age of(53.65±12.50)years old.All the patients underwent Kirschner wire and tension band fixation and suturing.The conventional anterior and posterior films of knee joint on the affected side were obtained before operation.The conventional anterior and posterior films of knee joint and relevant indexes were obtained during regular outpatient follow-up after operation.The clinical efficacy of such surgical method was assessed based on postoperative fractures healing,maximum flexion of knee joint on the affected side,comparison of positions of patellar on the healthy and affected sides before and after operation,postoperative Bostman patellar function score and complications after fractures operation.The results were statistically analyzed by using SPSS22.0 software,and P<0.05 was considered to suggest statistical significance.Result:All the patients were followed up effectively,and the mean follow-up period was(13.52±5.32)months.Bony healing was observed in all the patients three months later,with no nonunion of fractures or bone ununion three months after operation.There was no statistically significant difference between the maximum flexion degrees of knee joints on the affected side(130.43±3.34°)and on the healthy side(130.78±4.10°)six months after operation(P=0.41>0.05).Position of patellar was measured by Blumensaat's line: healthy side:(2.17±0.90cm);affected side:(2.18±0.91cm),with no statistically significant difference between the two sides(P=0.318>0.05).Bostman patellar function score of affected side six months after operation: 10 cases had an excellent result and 36 cases had a good result,with an excellent and good rate of 100%.The average Bostman score was(28.02±1.09)points.Postoperative follow-up found that 3 patients had knee joint motion pain,and X-ray films of 2 patients suggested slight displacement of Kirschner wire.The remaining patients who were followed up had no incision infection,neural or vascular injury,postoperative dislocation of fractures,flexion and extension dysfunction of the affected side or other complications.Conclusion: For the treatment for fractures of inferior patellar,Kirschner wire and tension band fixation and suturing can achieve satisfying anatomical reduction,help recover the function of knee joint well and achieve a definite clinical effect.While,there are complications such as kirschner wire displacement,skin irritation and wire loosening.