Effectiveness of high strength suture fixation in treatment of patellar transverse fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Jian , TANG Xiaobo ,  DONG Peilong , LI Zhiyun

Department of Orthopedics, Jianhu Hospital Affiliated to Nantong University, Yancheng Jiangsu, 224700, P.R.China;

Corresponding author：

DONG Peilong, Email: peipei198205@sina.com

Keywords：

Patellar fracture; transverse fracture; high strength suture; internal fixation

DOI：

10.7507/1002-1892.201712082

Video：

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ObjectiveTo explore the effectiveness of high strength suture fixation in treatment of patellar transverse fracture.MethodsBetween June 2014 and June 2016, 38 patients with the patellar transverse fracture were treated with high strength suture internal fixation. There were 24 males and 14 females with the age of 26 to 64 years (mean, 45 years). There were 6 cases of accident injury and 32 cases of crashing injury. The time interval between injury and surgery was 2-8 days (mean, 5 days). The preoperative visual analogue scale (VAS) score, Lysholm score, and range of motion (ROM) of patients were 84.3±8.4, 44.5±7.2, and (62±12)°, respectively.ResultsAll patients’ incisions healed by first intention after operation. There was no neurovascular injury, deep venous thrombosis of lower limbs, or local foreign matter irritation reaction. The X-ray films showed that the reduction of patella and the location of internal fixator were good at 2 days after operation. All the 38 patients were followed up 12-18 months (mean, 16 months). All fractures healed and the healing time was 2-4 months (mean, 3 months). At last follow-up, according to the Böstman criteria, 36 patients were rated as excellent and 2 as good, with an excellent and good rate of 100%. The VAS score, Lysholm score, and ROM of patients were 10.2±6.6, 93.1±6.4, and (124±14)°, respectively, showing significant differences when compared with preoperative ones (t=42.759, P=0.000; t=31.099, P=0.000; t=20.727, P=0.000).ConclusionApplication of high strength suture fixation in the treatment of patellar transverse fracture has advantages of simple to operate, effective fixation, and less complication. It can avoid reoperation of removing the internal fixators. The satisfied ROM and function of the knee joint can be obtained after operation.

Citation： WANG Jian, TANG Xiaobo, DONG Peilong, LI Zhiyun. Effectiveness of high strength suture fixation in treatment of patellar transverse fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(6): 694-697. doi: 10.7507/1002-1892.201712082 Copy

1.	李佳, 李石伦, 刘勃, 等. 2010年至2011年中国东部地区与西部地区成人髌骨骨折的流行病学对比分析. 中华创伤骨科杂志, 2016, 18 (11): 975-980.
2.	陈春永, 叶君健, 谢昀, 等. 单根钛缆环扎结合" 8”字张力带治疗髌骨骨折疗效观察. 中国修复重建外科杂志, 2017, 31(7): 805-809.
3.	李明东, 黎早敏, 陈剑飞, 等. 三种内固定方式治疗髌骨骨折的疗效分析. 中华创伤骨科杂志, 2017, 19(6): 532-536.
4.	Vidal C, Guingand O, de Thomasson E, et al. Painful patellofemoral instability secondary to peroperative patellar fracture during bone-patellar tendon-bone autograft harvesting for anterior cruciate ligament reconstruction. Orthop Traumatol Surg Res, 2012, 98(6): 733-735.
5.	李军, 石志刚, 付宇, 等. 带线锚钉结合Krackow-" 8”字缝合法治疗髌骨下极骨折的疗效观察. 中华全科医学, 2017, 15(8): 1280-1282.
6.	Gwinner C, Märdian S, Schwabe P, et al. Current concepts review: Fractures of the patella. GMS Interdiscip Plast Reconstr Surg DGPW, 2016, 5: Doc01.
7.	Hsu KL, Chang WL, Yang CY, et al. Factors affecting the outcomes of modified tension band wiring techniques in transverse patellar fractures. Injury, 2017, 48(12): 2800- 2806.
8.	Greenberg A, Kadar A, Drexler M, et al. Functional outcome after removal of hardware in patellar fracture: are we helping our patients? Arch Orthop Trauma Surg, 2018, 138(3): 325-330.
9.	Böstman O, Kiviluoto O, Nirhamo J. Comminuted displaced fractures of the patella. Injury, 1981, 13(3): 196-202.
10.	Başarir K, Erdemli B, Tuccar E, et al. Safe zone for the descending genicular artery in the midvastus approach to the knee. Clin Orthop Relat Res, 2006, 451: 96-100.
11.	Oliver WM, Shaikh AG, Wood AM. 34-week follow-up of suture anchor fixation for a traumatic patellar fracture overlying a total knee arthroplasty. Journal of Arthroscopy and Joint Surgery, 2015, 2(3): 136-139.
12.	Schuett DJ, Hake ME, Mauffrey C, et al. Current treatment strategies for patella fractures. Orthopedics, 2015, 38(6): 377-384.
13.	King AH, Engasser WM, Sousa PL, et al. Patellar fracture following patellofemoral arthroplasty. J Arthroplasty, 2015, 30(7): 1203-1206.
14.	Blum L, Hake M. ORIF patella fracture with a tension band construct. J Orthop Trauma, 2017, 31( Suppl 3): S8-S9.
15.	Sinha R, Joshi A, Kayastha N, et al. Bilateral traumatic patella fracture. Medical Journal of Shree Birendra Hospital, 2014, 13 (1): 43-45.
16.	朱云峰, 徐峰, 郝烨, 等. 关节镜辅助下治疗粉碎性髌骨骨折. 中国矫形外科杂志, 2017, 25(24): 2224-2228.
17.	Bryant TL, Anderson CL, Stevens CG, et al. Comparison of cannulated screws with FiberWire or stainless steel wire for patella fracture fixation: A pilot study. J Orthop, 2014, 12(2): 92-96.
18.	Cho JW, Kim J, Cho WT, et al. Comminuted inferior pole fracture of patella can be successfully treated with rim-plate-augmented separate vertical wiring. Arch Orthop Trauma Surg, 2018, 138(2): 195-202.
19.	Siljander M, Koueiter DM, Gandhi S, et al. Outcomes following low-profile mesh plate osteosynthesis of patella fractures. J Knee Surg, 2018. [Epub ahead of print].
20.	Suh KT, Suh JD, Cho HJ. Open reduction and internal fixation of comminuted patellar fractures with headless compression screws and wiring technique. J Orthop Sci, 2018, 23(1): 97-104.
21.	Camarda L, La Gattuta A, Butera M, et al. FiberWire tension band for patellar fractures. J Orthop Traumatol, 2016, 17(1): 75-80.
22.	Camarda L, Morello S, Balistreri F, et al. Non-metallic implant for patellar fracture fixation: A systematic review. Injury, 2016, 47(8): 1613-1617.

1. 李佳, 李石伦, 刘勃, 等. 2010年至2011年中国东部地区与西部地区成人髌骨骨折的流行病学对比分析. 中华创伤骨科杂志, 2016, 18 (11): 975-980.
2. 陈春永, 叶君健, 谢昀, 等. 单根钛缆环扎结合" 8”字张力带治疗髌骨骨折疗效观察. 中国修复重建外科杂志, 2017, 31(7): 805-809.
3. 李明东, 黎早敏, 陈剑飞, 等. 三种内固定方式治疗髌骨骨折的疗效分析. 中华创伤骨科杂志, 2017, 19(6): 532-536.
4. Vidal C, Guingand O, de Thomasson E, et al. Painful patellofemoral instability secondary to peroperative patellar fracture during bone-patellar tendon-bone autograft harvesting for anterior cruciate ligament reconstruction. Orthop Traumatol Surg Res, 2012, 98(6): 733-735.
5. 李军, 石志刚, 付宇, 等. 带线锚钉结合Krackow-" 8”字缝合法治疗髌骨下极骨折的疗效观察. 中华全科医学, 2017, 15(8): 1280-1282.
6. Gwinner C, Märdian S, Schwabe P, et al. Current concepts review: Fractures of the patella. GMS Interdiscip Plast Reconstr Surg DGPW, 2016, 5: Doc01.
7. Hsu KL, Chang WL, Yang CY, et al. Factors affecting the outcomes of modified tension band wiring techniques in transverse patellar fractures. Injury, 2017, 48(12): 2800- 2806.
8. Greenberg A, Kadar A, Drexler M, et al. Functional outcome after removal of hardware in patellar fracture: are we helping our patients? Arch Orthop Trauma Surg, 2018, 138(3): 325-330.
9. Böstman O, Kiviluoto O, Nirhamo J. Comminuted displaced fractures of the patella. Injury, 1981, 13(3): 196-202.
10. Başarir K, Erdemli B, Tuccar E, et al. Safe zone for the descending genicular artery in the midvastus approach to the knee. Clin Orthop Relat Res, 2006, 451: 96-100.
11. Oliver WM, Shaikh AG, Wood AM. 34-week follow-up of suture anchor fixation for a traumatic patellar fracture overlying a total knee arthroplasty. Journal of Arthroscopy and Joint Surgery, 2015, 2(3): 136-139.
12. Schuett DJ, Hake ME, Mauffrey C, et al. Current treatment strategies for patella fractures. Orthopedics, 2015, 38(6): 377-384.
13. King AH, Engasser WM, Sousa PL, et al. Patellar fracture following patellofemoral arthroplasty. J Arthroplasty, 2015, 30(7): 1203-1206.
14. Blum L, Hake M. ORIF patella fracture with a tension band construct. J Orthop Trauma, 2017, 31( Suppl 3): S8-S9.
15. Sinha R, Joshi A, Kayastha N, et al. Bilateral traumatic patella fracture. Medical Journal of Shree Birendra Hospital, 2014, 13 (1): 43-45.
16. 朱云峰, 徐峰, 郝烨, 等. 关节镜辅助下治疗粉碎性髌骨骨折. 中国矫形外科杂志, 2017, 25(24): 2224-2228.
17. Bryant TL, Anderson CL, Stevens CG, et al. Comparison of cannulated screws with FiberWire or stainless steel wire for patella fracture fixation: A pilot study. J Orthop, 2014, 12(2): 92-96.
18. Cho JW, Kim J, Cho WT, et al. Comminuted inferior pole fracture of patella can be successfully treated with rim-plate-augmented separate vertical wiring. Arch Orthop Trauma Surg, 2018, 138(2): 195-202.
19. Siljander M, Koueiter DM, Gandhi S, et al. Outcomes following low-profile mesh plate osteosynthesis of patella fractures. J Knee Surg, 2018. [Epub ahead of print].
20. Suh KT, Suh JD, Cho HJ. Open reduction and internal fixation of comminuted patellar fractures with headless compression screws and wiring technique. J Orthop Sci, 2018, 23(1): 97-104.
21. Camarda L, La Gattuta A, Butera M, et al. FiberWire tension band for patellar fractures. J Orthop Traumatol, 2016, 17(1): 75-80.
22. Camarda L, Morello S, Balistreri F, et al. Non-metallic implant for patellar fracture fixation: A systematic review. Injury, 2016, 47(8): 1613-1617.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of high strength suture fixation in treatment of patellar transverse fracture

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