Huai Ming Phen, Kathryn A Barth, Robert E Bilodeau, Craig E Klinger, Christopher M Brusalis, William M Ricci
{"title":"髌骨骨折背侧钩状钢板固定术可立即活动,固定可靠,植入物取出率低,临床效果令人满意。","authors":"Huai Ming Phen, Kathryn A Barth, Robert E Bilodeau, Craig E Klinger, Christopher M Brusalis, William M Ricci","doi":"10.1097/BOT.0000000000002809","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate radiographic and clinical patient-reported outcomes following dorsal hook plating of displaced patella fractures with permittance of immediate postoperative active closed chain range of motion.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>Retrospective review of prospectively collected data.</p><p><strong>Setting: </strong>Urban academic level 1 trauma center.</p><p><strong>Patient selection criteria: </strong>Adult patients with displaced patella fractures (OTA/AO 34C1-3) who underwent dorsal plating with immediate range of motion between 2018 and 2023.</p><p><strong>Outcome measures and comparisons: </strong>Numerical Rating Scale for Pain, Knee Outcome Score (KOS-ADL), Tegner-Lysholm score, radiographic union, and wound complications were collected.</p><p><strong>Results: </strong>Sixty-one patients were included (47 female) with an average age of 63 years (SD 14.7, range 22-86 years). The mean BMI was 24.2 (SD 3.6, range 16.6-33.3). There were 13 34-C2 and 48 34-C3 fractures. All but 2 patients (96.7%) achieved bony union after the index procedure. 89% (n = 54) of patients completed outcome surveys with at least 6-month follow-up. Six patients (9.8%) underwent removal of plate implant at a mean of 15.1 months postoperatively. The mean KOS-ADL score was 91.4, the mean Tegner-Lysholm score was 78.1, and the mean NRS was 2.7.</p><p><strong>Conclusions: </strong>Dorsal hook plating offers secure fixation to allow early range of motion, reliable fixation with low nonunion and implant failure rates, low implant removal rates, and satisfactory patient-reported outcomes.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dorsal Hook Plating of Patella Fractures With Immediate Range of Motion Results in Reliable Fixation, Low Implant Removal Rates, and Satisfactory Clinical Outcomes.\",\"authors\":\"Huai Ming Phen, Kathryn A Barth, Robert E Bilodeau, Craig E Klinger, Christopher M Brusalis, William M Ricci\",\"doi\":\"10.1097/BOT.0000000000002809\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate radiographic and clinical patient-reported outcomes following dorsal hook plating of displaced patella fractures with permittance of immediate postoperative active closed chain range of motion.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>Retrospective review of prospectively collected data.</p><p><strong>Setting: </strong>Urban academic level 1 trauma center.</p><p><strong>Patient selection criteria: </strong>Adult patients with displaced patella fractures (OTA/AO 34C1-3) who underwent dorsal plating with immediate range of motion between 2018 and 2023.</p><p><strong>Outcome measures and comparisons: </strong>Numerical Rating Scale for Pain, Knee Outcome Score (KOS-ADL), Tegner-Lysholm score, radiographic union, and wound complications were collected.</p><p><strong>Results: </strong>Sixty-one patients were included (47 female) with an average age of 63 years (SD 14.7, range 22-86 years). The mean BMI was 24.2 (SD 3.6, range 16.6-33.3). There were 13 34-C2 and 48 34-C3 fractures. All but 2 patients (96.7%) achieved bony union after the index procedure. 89% (n = 54) of patients completed outcome surveys with at least 6-month follow-up. Six patients (9.8%) underwent removal of plate implant at a mean of 15.1 months postoperatively. The mean KOS-ADL score was 91.4, the mean Tegner-Lysholm score was 78.1, and the mean NRS was 2.7.</p><p><strong>Conclusions: </strong>Dorsal hook plating offers secure fixation to allow early range of motion, reliable fixation with low nonunion and implant failure rates, low implant removal rates, and satisfactory patient-reported outcomes.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>\",\"PeriodicalId\":16644,\"journal\":{\"name\":\"Journal of Orthopaedic Trauma\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic Trauma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BOT.0000000000002809\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Trauma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BOT.0000000000002809","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Dorsal Hook Plating of Patella Fractures With Immediate Range of Motion Results in Reliable Fixation, Low Implant Removal Rates, and Satisfactory Clinical Outcomes.
Objectives: To evaluate radiographic and clinical patient-reported outcomes following dorsal hook plating of displaced patella fractures with permittance of immediate postoperative active closed chain range of motion.
Methods:
Design: Retrospective review of prospectively collected data.
Setting: Urban academic level 1 trauma center.
Patient selection criteria: Adult patients with displaced patella fractures (OTA/AO 34C1-3) who underwent dorsal plating with immediate range of motion between 2018 and 2023.
Outcome measures and comparisons: Numerical Rating Scale for Pain, Knee Outcome Score (KOS-ADL), Tegner-Lysholm score, radiographic union, and wound complications were collected.
Results: Sixty-one patients were included (47 female) with an average age of 63 years (SD 14.7, range 22-86 years). The mean BMI was 24.2 (SD 3.6, range 16.6-33.3). There were 13 34-C2 and 48 34-C3 fractures. All but 2 patients (96.7%) achieved bony union after the index procedure. 89% (n = 54) of patients completed outcome surveys with at least 6-month follow-up. Six patients (9.8%) underwent removal of plate implant at a mean of 15.1 months postoperatively. The mean KOS-ADL score was 91.4, the mean Tegner-Lysholm score was 78.1, and the mean NRS was 2.7.
Conclusions: Dorsal hook plating offers secure fixation to allow early range of motion, reliable fixation with low nonunion and implant failure rates, low implant removal rates, and satisfactory patient-reported outcomes.
Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
期刊介绍:
Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.