Progress in the surgical treatment of the patellar fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Guanglei ¹ ,  LIU Ping ^1,2

1. Department of Orthopedics, Liyuan Hospital Affiliated to Tongji Medical School of Huazhong University of Science and Technology, Wuhan Hubei, 430077, P.R.China;
2. Physical Examination Center, Liyuan Hospital Affiliated to Tongji Medical School of Huazhong University of Science and Technology, Wuhan Hubei, 430077, P.R.China;

Corresponding?author：

LIU Ping, Email: liuping791005@139.com

Keywords：

Patellar fracture; surgical treatment; research progress

DOI：

10.7507/1002-1892.202104068

Video：

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Objective To review research progress of surgical treatment of patellar fractures.Methods The domestic and foreign literature about patellar fracture treatment in recent years was extensively consulted, and the advantages, disadvantages, and indications of various surgical treatments were summarized.Results The patella plays an important role in knee flexion and extension activities, and the fracture significantly affects the patient’s quality of life. At present, the surgical methods include open reduction and internal fixation and patella resection. The internal fixation methods include ring/binding patella fixation, tension band wiring and improved technology, tension band wiring combined with other methods, screw fixation (including absorbable screws), steel plate fixation, and patella fixator fixation. Each surgical method has different indications, advantages, and disadvantages. Choosing an appropriate treatment plan plays a crucial role in clinical prognosis.Conclusion There are many surgical treatments for patellar fractures. In order to improve the effectiveness and reduce postoperative complications, it is necessary to choose the most appropriate treatment strategy for the type of fracture.

Citation： LI Guanglei, LIU Ping. Progress in the surgical treatment of the patellar fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(8): 1057-1062. doi: 10.7507/1002-1892.202104068 Copy

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7.	Oh HK, Choo SK, Kim JW, et al. Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing. Injury, 2015, 46(12): 2512-2515.
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1. Damrow DS, Van Valin SE. Patellar sleeve fracture with ossification of the patellar tendon. Orthopedics, 2017, 40(2): e357-e359.
2. 馬春濤, 譚昱, 肖育志, 等. 關節鏡輔助下復位后經皮空心螺釘聯合鋼絲張力帶內固定治療髕骨粉碎性骨折的臨床研究. 中國醫師雜志, 2019, 21(6): 825-829.
3. Martin JM, Applin DT, McGrady LM, et al. Biomechanical comparison of tension band fixation of patella transverse fracture: headless screws versus headed screws. J Orthop Trauma, 2019, 33(6): e240-e245.
4. Kfuri M, Escalante I, Schopper C, et al. Comminuted patellar fractures: The role of biplanar fixed angle plate constructs. J Orthop Translat, 2020, 27: 17-24.
5. 白曉東, 蘆重堯. 髕骨骨折的內固定治療進展. 河北醫科大學學報, 2020, 41(7): 865-868.
6. Zderic I, Stoffel K, Sommer C, et al. Biomechanical evaluation of the tension band wiring principle. A comparison between two different techniques for transverse patella fracture fixation. Injury, 2017, 48(8): 1749-1757.
7. Oh HK, Choo SK, Kim JW, et al. Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing. Injury, 2015, 46(12): 2512-2515.
8. 李富文, 黃小忠, 唐會蓮, 等. Krachow 縫合聯合改良環扎張力帶固定髕骨下極粉碎性骨折. 中國骨科臨床與基礎研究雜志, 2019, 11(6): 343-347.
9. 宋大衛, 張成棟, 于丕學, 等. Krachow法縫合聯合鋼絲垂直間斷固定治療髕骨下極粉碎性骨折. 中國臨床研究, 2020, 33(9): 1221-1223.
10. 李述柏. 三角形捆綁法在髕骨骨折手術中應用分析. 中國冶金工業醫學雜志, 2020, 37(4): 453-454.
11. Chen M, Jin X, Fryhofer GW, et al. The application of the Nice knots as an auxiliary reduction technique in displaced comminuted patellar fractures. Injury, 2020, 51(2): 466-472.
12. Hasegawa S, Ishii S, Tamura J, et al. A 5-7 year in vivo study of high-strength hydroxyapatite/poly (L-lactide) composite rods for the internal fixation of bone fractures. Biomaterials, 2006, 27(8): 1327-1332.
13. Ueki K, Okabe K, Moroi A, et al. Maxillary stability after Le FortⅠosteotomy using three different plate systems. Int J Oral Maxillofac Surg, 2012, 41(8): 942-948.
14. Usami T, Takada N, Sakai H, et al. Treatment of patellar fractures using bioresorbable forged composites of raw particulate unsintered hydroxyapatite/poly-L-lactide cannulated screws and nonabsorbable sutures. Injury, 2021, 52(6): 1587-1591.
15. Müller EC, Frosch KH. Functional outcomes of revision osteosynthesis after failure of surgical treatment of patellar fractures. J Knee Surg, 2021, 34(1): 80-86.
16. 郭大興, 蘇暢, 李清. 帶孔克氏針結合改良張力帶鋼絲技術治療髕骨骨折療效觀察. 山西醫藥雜志, 2020, 49(16): 2131-2132.
17. 王新國, 蔡增彬, 譚廣毅, 等. 髕骨針+鈦纜固定治療髕骨骨折. 臨床骨科雜志, 2020, 23(3): 398.
18. 陳建球, 陳榮莊, 石通和, 等. 髕骨針鈦纜內固定與髕骨爪內固定治療髕骨骨折的臨床效果比較. 中外醫學研究, 2020, 18(9): 146-148.
19. Zhu XZ, Huang TL, Zhu HY, et al. A retrospective cohort study on prevalence of postoperative complications in comminuted patellar fractures: comparisons among stabilized with cannulated-screw, Kirschner-wire, or ring-pin tension bands. BMC Musculoskelet Disord, 2021, 22(1): 60. doi: 10.1186/s12891-020-03936-5.
20. Elkin DM, Galloway JD, Koury K, et al. Patella fracture fixation with a non-locked anterior plating technique: A biomechanical study. Injury, 2021, 52(4): 686-691.
21. 張旭, 吳建偉, 李岳瑞. 空心釘張力帶與克氏針張力帶治療老年性髕骨骨折的效果對比觀察. 中醫臨床研究, 2018, 10(7): 132-133.
22. 亞力坤·亞森, 米爾亞庫甫·麥麥提斯迪克, 徐超, 等. 新型張力帶系統治療髕骨橫形骨折. 醫學研究雜志, 2020, 49(9): 128-131.
23. Lee KH, Lee Y, Lee YH, et al. Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins. J Orthop Surg (Hong Kong), 2019, 27(3): 2309499019882140. doi: 10.1177/2309499019882140.
24. Khan I, Dar MY, Rashid S, et al. Internal fixation of transverse patella fractures using cannulated cancellous screws with anterior tension band wiring. Malays Orthop J, 2016, 10(2): 21-26.
25. Zha K, Liu GH, Yang SH, et al. Cable pin system versus K-wire tension band fixation for patella fractures in Chinese Han population: A meta-analysis. J Huazhong Univ Sci Technolog Med Sci, 2017, 37(5): 667-674.
26. 趙磊, 王鋼銳, 王強, 等. 改良Cable-Pin系統治療髕骨骨折. 臨床骨科雜志, 2018, 21(6): 758.
27. Adjal J, Ban I. Patella fractures treated with suture tension band fixation. J Orthop Surg Res, 2021, 16(1): 179. doi: 10.1186/s13018-021-02309-5.
28. 王立祚, 敖傳西, 王奎, 等. 預斷式帶孔克氏針張力帶結合PDSⅡ線荷包縫合治療髕骨粉碎性骨折. 創傷外科雜志, 2021, 23(1): 23-27.
29. Müller EC, Frosch KH. Plate osteosynthesis of patellar fractures. Oper Orthop Traumatol, 2017, 29(6): 509-519.
30. 劉晨陽. 關節鏡下經皮空心螺釘張力帶內固定治療粉碎性髕骨骨折患者的臨床研究. 首都食品與醫藥, 2020, 27(12): 46.
31. 肖凱, 趙慶華, 張寬寬. 關節鏡輔助下微創克氏針張力帶內固定對髕骨骨折患者骨代謝和體液免疫功能的影響. 中國內鏡雜志, 2021, 27(3): 51-58.
32. 陳文盛. 63例髕骨骨折記憶合金髕骨爪內固定治療的探討. 中外醫療, 2018, 37(9): 51-53.
33. 趙建華, 梁源清, 劉崗, 等. 改良鋼絲環扎聯合髕骨爪固定與傳統張力帶固定治療粉碎性髕骨骨折的療效比較. 國際感染病學 (電子版), 2020, 9(2): 36-38.
34. 梁吉華, 邵偉忠, 史源欣, 等. 分體式髕骨爪結合可吸收線治療粉碎性髕骨骨折. 臨床骨科雜志, 2018, 21(1): 107-108.
35. 王奇, 張瀾藝, 李海亮, 等. 髕骨環內固定治療髕骨粉碎性骨折臨床療效分析. 中國中西醫結合外科雜志, 2020, 26(6): 1155-1158.
36. 郭方, 賀志強, 余勤武, 等. 髕骨骨折不同治療方法的臨床療效比較及治療策略. 中國繼續醫學教育, 2017, 9(30): 71-73.
37. Singh S, Surana R, Rai A, et al. Outcome analysis of fixed angle locking plate in patella fractures: a single centre experience from North India. Indian J Orthop, 2020, 55(3): 655-661.
38. Ellwein A, Lill H, DeyHazra RO, et al. Outcomes after locked plating of displaced patella fractures: a prospective case series. Int Orthop, 2019, 43(12): 2807-2815.
39. 劉峰. 指掌骨鎖定鋼板內固定治療髕骨骨折的臨床觀察. 中國民間療法, 2020, 28(8): 85-86.
40. 劉兵, 馬翔宇, 宋夏楠, 等. 微型鎖定鋼板治療髕骨冠狀面骨折臨床效果觀察. 臨床軍醫雜志, 2020, 48(4): 383-385.
41. Shymon SJ, Jansson H, Schneiderman BA, et al. Functional outcomes of patella fractures treated with anterior plate osteosynthesis at one year. J Orthop Trauma, 2021, 35(1): e1-e6.
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