A clinical analysis of two internal fixation methods for the treatment of inferior patellar fracture

ZHANG Zhao; XU Shi-ming; XIANG Qian; HUANG Dong

doi:10.3969/j.issn.2095-252X.2019.03.013

Abstract：Objective To compare the clinical effects of two different internal fixation methods for the treatment of patellar inferior polar fracture, and provide references for clinical treatment and internal fixator selection.Methods A total of 32 patients with AO/OTA 34-A1 in the department of orthopedics of our hospital from January2014 to May 2017 were analyzed. All were divided into the observation group and control group with 16 cases in each group. The observation group underwent open reduction and internal fixation with intermittent vertical wire suture combined with Krachow suture; the control group underwent open reduction and internal fixation with patellar claw.Follow up ranged 12-23 months with an average of ( 16.2 ± 0.30) months. Healing time, complications, knee pain, flexion and extension activity range ( range of motion, ROM), B?stman scores and other indicators were compared between the 2 groups. Results The average fracture healing time was ( 2.76 ± 0.43) months in the observation group and ( 2.79 ± 0.52) months in the control group with no significant differences ( P = 0.08). Postoperative incisions of the two groups healed at stage I with no complications. The range of flexion and extension of the knee joint in the observation group was ( 129.4 ± 0.43) °, and ( 129.1 ± 0.51) ° in the control group. The B?stman score of the knee joint in the observation group was ( 29.6 ± 0.23) and the control group ( 29.4 ± 0.20). Conclusions ( 1) The excellent rates of lower patellar fracture healing in the two groups are high, showing effective results. ( 2) Intermittent vertical wire suture combined with Krackow suture can maintain the integrity of the patellar tendon to the maximum extent and knee joint function, which is also easy to operate and fix. ( 3) It is beneficial to the early functional exercise. It has more extensive adaptability to the fracture of the patella and is low in cost, with a broad prospect of application and popularization.