Comparison of the treatment of patellar inferior pole fractures with combined vertical wire and mini steel plate fixation versus independent vertical wire fixation

IF 1.6 4区 医学 Q3 ORTHOPEDICS Knee Pub Date : 2024-11-11 DOI:10.1016/j.knee.2024.09.015
Yan Dong, Weichun Huang, Lihong Wei, Yingxun Du, Bingmin Lin
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Abstract

Background

Patellar fractures, in particular inferior pole fractures, pose significant challenges due to the patella’s complex biomechanics and crucial role in knee extension and stability. This study aimed to compare the therapeutic effectiveness and long-term efficacy of two fixation methods: combined vertical wire and mini steel plate fixation versus independent vertical wire fixation. The comparison was based on clinical classification, addressing the ongoing debate regarding optimal management strategies for patellar inferior pole fractures.

Methods

A retrospective cohort study was conducted, analyzing 226 patients with patellar inferior pole fractures. Patients were divided into two groups: the independent vertical wire fixation group (n = 117) and the combined vertical wire and mini steel plate fixation group (n = 109). Demographic data, clinical characteristics, surgical outcomes, functional outcomes, pain levels, return to daily activities, quality of life, and both short-term and long-term complications were assessed and compared between the two groups.

Results

The combined fixation group demonstrated significantly superior surgical outcomes, including shorter operation times and lower infection rates, despite higher blood loss. Furthermore, this group exhibited enhanced functional outcomes, reduced pain levels, and lower rates of osteoarthritis and salvage procedures compared with the independent fixation group.

Conclusions

The findings of this study suggest potential advantages of combined vertical wire and mini steel plate fixation over independent vertical wire fixation in the treatment of patellar inferior pole fractures. The combined fixation method was associated with improved surgical outcomes, enhanced functional recovery, better pain management, and reduced long-term complication rates.
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髌骨下极骨折垂直钢丝和微型钢板联合固定与独立垂直钢丝固定治疗的比较。
背景:髌骨骨折,尤其是下极骨折,由于髌骨复杂的生物力学特性以及在膝关节伸展和稳定性中的关键作用,给治疗带来了巨大挑战。本研究旨在比较两种固定方法的治疗效果和长期疗效:垂直钢丝和微型钢板联合固定与独立垂直钢丝固定。比较以临床分类为基础,以解决目前关于髌骨下极骨折最佳治疗策略的争论:这项回顾性队列研究分析了 226 名髌骨下极骨折患者。患者分为两组:独立垂直钢丝固定组(117 人)和垂直钢丝与微型钢板联合固定组(109 人)。对两组患者的人口统计学数据、临床特征、手术效果、功能效果、疼痛程度、日常活动恢复情况、生活质量以及短期和长期并发症进行评估和比较:结果:尽管失血较多,但联合固定组的手术效果明显优于其他组,包括手术时间更短,感染率更低。此外,与独立固定组相比,联合固定组的功能效果更好,疼痛程度更轻,骨关节炎和挽救手术的发生率更低:本研究结果表明,在治疗髌骨下极骨折时,垂直钢丝和微型钢板联合固定比独立垂直钢丝固定具有潜在优势。联合固定法可改善手术效果、促进功能恢复、改善疼痛控制并降低长期并发症发生率。
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来源期刊
Knee
Knee 医学-外科
CiteScore
3.80
自引率
5.30%
发文量
171
审稿时长
6 months
期刊介绍: The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.
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