Analysis of reasons for internal fixation failure after internal fixation of patella fracture with nickel-titanium memory alloy patella claw and its countermeasures_West China Medical Journal

Authors：

LIANG Haisong ¹ , DENG Yu ¹ ,  HUI Xiaosu ² , BAI Xinwen ¹ , SHENG Dong ¹ , JIANG Renjian ³

1. Second Orthopedic Ward, Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400010, P. R. China;
2. Department of Anorectal, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400000, P. R. China;
3. Department of Orthopedics, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400000, P. R. China;

Corresponding author：

HUI Xiaosu, Email: 514608953@qq.com

Keywords：

Patellar fracture; Patella claw; Internal fixation failure

DOI：

10.7507/1002-0179.202006102

Video：

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Objective To analyze the reasons for internal fixation failure after internal fixation of nickel-titanium memory alloy patella claw for patella fracture, and to explore the countermeasures. Methods The clinical data of patients with patellar fracture treated by internal fixation of nickel-titanium memory alloy patella claw in the Second Orthopedic Ward of Chongqing Orthopedic Hospital of Traditional Chinese Medicine from May 2015 to April 2020 were analyzed retrospectively. Patients with postoperative internal fixation failure were identified. The reasons for internal fixation failure were analyzed. Results A total of 436 patients were included. Internal fixation failure occurred in 10 patients. There were 6 cases (1.38%) of patellar claw detachment, and 4 cases of simple fracture block displacement witharticular surface displacement≥2 mm (0.92%). Internal fixation failure occurred 4 to 48 days postoperatively, with an average of (18.20±10.86)days. The analysis showed that the reason for internal fixation failure in 4 patients was improper early postoperative functional exercise. The reason for 3 patients was that the auxiliary internal fixation was not selected. The reason for 2 patients was that the size of the patellar claw was too small. The reason for 1 patient was the improper fixation of the auxiliary internal fixation. Conclusion The failure of internal fixation after patella fracture with nickel-titanium memory alloy patella claw is mainly related to whether the model of the patella claw is appropriate, whether the auxiliary internal fixation is selected, whether the auxiliary internal fixation is properly fixed, and whether the early postoperative functional exercise is appropriate.

Citation： LIANG Haisong, DENG Yu, HUI Xiaosu, BAI Xinwen, SHENG Dong, JIANG Renjian. Analysis of reasons for internal fixation failure after internal fixation of patella fracture with nickel-titanium memory alloy patella claw and its countermeasures. West China Medical Journal, 2021, 36(10): 1361-1365. doi: 10.7507/1002-0179.202006102 Copy

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2.	Dickens AJ, Salas C, Rise L, et al. Titanium mesh as a low-profile alternative for tension-band augmentation in patella fracture fixation: a biomechanical study. Injury, 2015, 46(6): 1001-1006.
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7.	张钊, 徐世明, 向茜, 等. 两种内固定方法治疗髌骨下极骨折临床疗效的对比分析. 中国骨与关节杂志, 2019, 8(3): 220-224.
8.	刘欣伟, 苏佳灿, 张春才, 等. 生理性成骨力值概念在镍钛聚髌器置入治疗髌骨骨折的应用: 106例回顾. 中国组织工程研究与临床康复, 2008(17): 3225-3228.
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10.	曲连军, 李忠, 刘学胜, 等. 可分离式髌骨爪治疗髌骨粉碎性骨折. 中国骨与关节损伤杂志, 2009, 24(3): 252-253.
11.	Du D, Wu Z, Xing J, et al. Finite element analysis of mechanics property on memory alloy patella claws with anti-shearing force. Appl Mech Mater, 2014: 507-510.
12.	喻永新, 陈曙辉, 肖彦, 等. 髌骨骨折记忆合金环抱器手术失败原因探讨. 医学信息, 2009, 22(10): 1330-1332.
13.	耿震, 林永杰, 王国伟, 等. 带线锚钉结合髌骨爪治疗髌骨下极骨折. 中国矫形外科杂志, 2019, 27(14): 1330-1332.
14.	夏淑文, 黄国平. 克氏针联合镍钛记忆合金髌骨爪内固定治疗髌骨粉碎性骨折. 江西医药, 2017, 52(10): 1002-1003.
15.	余专一, 周江军, 赵敏, 等. 髌骨爪结合克氏针张力带治疗髌骨下极粉碎性骨折. 中华关节外科杂志(电子版), 2018, 12(2): 280-283.
16.	夏涛. 记忆合金髌骨爪内固定治疗复杂性粉碎性髌骨骨折的疗效分析. 实用临床医药杂志, 2018, 22(21): 82-85.
17.	黄东红, 卢启贵, 李长树, 等. 聚髌器联合克氏针内固定治疗髌骨骨折. 中国中医骨伤科杂志, 2016, 24(5): 71-73.

1. Kadar A, Sherman H, Drexler M, et al. Anchor suture fixation of distal pole fractures of patella: twenty seven cases and comparison to partial patellectomy. Int Orthop, 2016, 40(1): 149-154.
2. Dickens AJ, Salas C, Rise L, et al. Titanium mesh as a low-profile alternative for tension-band augmentation in patella fracture fixation: a biomechanical study. Injury, 2015, 46(6): 1001-1006.
3. 戴传强, 李跃辉, 肖尧. 记忆合金髌骨爪治疗髌骨骨折失败原因分析. 四川医学, 2013, 34(12): 1888-1890.
4. 唐正标, 张成安, 刘建, 等. 镍钛记忆合金髌骨爪的材料学特点与髌骨骨折术后效果的关系. 中国组织工程研究与临床康复, 2007, 11(9): 1771.
5. 黎介寿, 吴孟超. 手术学全集(矫形外科卷). 北京: 人民军医出版社, 1996.
6. 桂柯科, 尹望平, 俞永林. 镍钛形态记忆合金聚髌器治疗粉碎性髌骨骨折. 复旦学报(医学版), 2011, 38(3): 247-250.
7. 张钊, 徐世明, 向茜, 等. 两种内固定方法治疗髌骨下极骨折临床疗效的对比分析. 中国骨与关节杂志, 2019, 8(3): 220-224.
8. 刘欣伟, 苏佳灿, 张春才, 等. 生理性成骨力值概念在镍钛聚髌器置入治疗髌骨骨折的应用: 106例回顾. 中国组织工程研究与临床康复, 2008(17): 3225-3228.
9. 王成润, 杨小龙. 记忆合金聚髌器联合可吸收线内固定治疗粉碎性髌骨骨折. 中国骨与关节损伤杂志, 2015, 30(10): 1039.
10. 曲连军, 李忠, 刘学胜, 等. 可分离式髌骨爪治疗髌骨粉碎性骨折. 中国骨与关节损伤杂志, 2009, 24(3): 252-253.
11. Du D, Wu Z, Xing J, et al. Finite element analysis of mechanics property on memory alloy patella claws with anti-shearing force. Appl Mech Mater, 2014: 507-510.
12. 喻永新, 陈曙辉, 肖彦, 等. 髌骨骨折记忆合金环抱器手术失败原因探讨. 医学信息, 2009, 22(10): 1330-1332.
13. 耿震, 林永杰, 王国伟, 等. 带线锚钉结合髌骨爪治疗髌骨下极骨折. 中国矫形外科杂志, 2019, 27(14): 1330-1332.
14. 夏淑文, 黄国平. 克氏针联合镍钛记忆合金髌骨爪内固定治疗髌骨粉碎性骨折. 江西医药, 2017, 52(10): 1002-1003.
15. 余专一, 周江军, 赵敏, 等. 髌骨爪结合克氏针张力带治疗髌骨下极粉碎性骨折. 中华关节外科杂志(电子版), 2018, 12(2): 280-283.
16. 夏涛. 记忆合金髌骨爪内固定治疗复杂性粉碎性髌骨骨折的疗效分析. 实用临床医药杂志, 2018, 22(21): 82-85.
17. 黄东红, 卢启贵, 李长树, 等. 聚髌器联合克氏针内固定治疗髌骨骨折. 中国中医骨伤科杂志, 2016, 24(5): 71-73.

West China Medical Journal

Analysis of reasons for internal fixation failure after internal fixation of patella fracture with nickel-titanium memory alloy patella claw and its countermeasures

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