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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Abstract Full text Figures/Tables Video References Cited by

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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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.	白晓东, 芦重尧. 髌骨骨折的内固定治疗进展. 河北医科大学学报, 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, 黄小忠, 唐会莲, 等. Krachow 缝合联合改良环扎张力带固定髌骨下极粉碎性骨折. 中国骨科临床与基础研究杂志, 2019, 11(6): 343-347.
9.	宋大卫, 张成栋, 于丕学, 等. Krachow法缝合联合钢丝垂直间断固定治疗髌骨下极粉碎性骨折. 中国临床研究, 2020, 33(9): 1221-1223.
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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.	郭大兴, 苏畅, 李清. 带孔克氏针结合改良张力带钢丝技术治疗髌骨骨折疗效观察. 山西医药杂志, 2020, 49(16): 2131-2132.
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28.	王立祚, 敖传西, 王奎, 等. 预断式带孔克氏针张力带结合PDSⅡ线荷包缝合治疗髌骨粉碎性骨折. 创伤外科杂志, 2021, 23(1): 23-27.
29.	Müller EC, Frosch KH. Plate osteosynthesis of patellar fractures. Oper Orthop Traumatol, 2017, 29(6): 509-519.
30.	刘晨阳. 关节镜下经皮空心螺钉张力带内固定治疗粉碎性髌骨骨折患者的临床研究. 首都食品与医药, 2020, 27(12): 46.
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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. 马春涛, 谭昱, 肖育志, 等. 关节镜辅助下复位后经皮空心螺钉联合钢丝张力带内固定治疗髌骨粉碎性骨折的临床研究. 中国医师杂志, 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. 白晓东, 芦重尧. 髌骨骨折的内固定治疗进展. 河北医科大学学报, 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, 黄小忠, 唐会莲, 等. Krachow 缝合联合改良环扎张力带固定髌骨下极粉碎性骨折. 中国骨科临床与基础研究杂志, 2019, 11(6): 343-347.
9. 宋大卫, 张成栋, 于丕学, 等. Krachow法缝合联合钢丝垂直间断固定治疗髌骨下极粉碎性骨折. 中国临床研究, 2020, 33(9): 1221-1223.
10. 李述柏. 三角形捆绑法在髌骨骨折手术中应用分析. 中国冶金工业医学杂志, 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. 郭大兴, 苏畅, 李清. 带孔克氏针结合改良张力带钢丝技术治疗髌骨骨折疗效观察. 山西医药杂志, 2020, 49(16): 2131-2132.
17. 王新国, 蔡增彬, 谭广毅, 等. 髌骨针+钛缆固定治疗髌骨骨折. 临床骨科杂志, 2020, 23(3): 398.
18. 陈建球, 陈荣庄, 石通和, 等. 髌骨针钛缆内固定与髌骨爪内固定治疗髌骨骨折的临床效果比较. 中外医学研究, 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. 张旭, 吴建伟, 李岳瑞. 空心钉张力带与克氏针张力带治疗老年性髌骨骨折的效果对比观察. 中医临床研究, 2018, 10(7): 132-133.
22. 亚力坤·亚森, 米尔亚库甫·麦麦提斯迪克, 徐超, 等. 新型张力带系统治疗髌骨横形骨折. 医学研究杂志, 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. 赵磊, 王钢锐, 王强, 等. 改良Cable-Pin系统治疗髌骨骨折. 临床骨科杂志, 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, 敖传西, 王奎, 等. 预断式带孔克氏针张力带结合PDSⅡ线荷包缝合治疗髌骨粉碎性骨折. 创伤外科杂志, 2021, 23(1): 23-27.
29. Müller EC, Frosch KH. Plate osteosynthesis of patellar fractures. Oper Orthop Traumatol, 2017, 29(6): 509-519.
30. 刘晨阳. 关节镜下经皮空心螺钉张力带内固定治疗粉碎性髌骨骨折患者的临床研究. 首都食品与医药, 2020, 27(12): 46.
31. 肖凯, 赵庆华, 张宽宽. 关节镜辅助下微创克氏针张力带内固定对髌骨骨折患者骨代谢和体液免疫功能的影响. 中国内镜杂志, 2021, 27(3): 51-58.
32. 陈文盛. 63例髌骨骨折记忆合金髌骨爪内固定治疗的探讨. 中外医疗, 2018, 37(9): 51-53.
33. 赵建华, 梁源清, 刘岗, 等. 改良钢丝环扎联合髌骨爪固定与传统张力带固定治疗粉碎性髌骨骨折的疗效比较. 国际感染病学 (电子版), 2020, 9(2): 36-38.
34. 梁吉华, 邵伟忠, 史源欣, 等. 分体式髌骨爪结合可吸收线治疗粉碎性髌骨骨折. 临床骨科杂志, 2018, 21(1): 107-108.
35. 王奇, 张澜艺, 李海亮, 等. 髌骨环内固定治疗髌骨粉碎性骨折临床疗效分析. 中国中西医结合外科杂志, 2020, 26(6): 1155-1158.
36. 郭方, 贺志强, 余勤武, 等. 髌骨骨折不同治疗方法的临床疗效比较及治疗策略. 中国继续医学教育, 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. 刘峰. 指掌骨锁定钢板内固定治疗髌骨骨折的临床观察. 中国民间疗法, 2020, 28(8): 85-86.
40. 刘兵, 马翔宇, 宋夏楠, 等. 微型锁定钢板治疗髌骨冠状面骨折临床效果观察. 临床军医杂志, 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.
42. 郭金伟, 杨博文, 张孝华, 等. 髌骨微型钢板与克氏针张力带内固定治疗髌骨骨折的疗效比较. 西南医科大学学报, 2019, 42(3): 253-256.
43. 江开明, 罗志军, 陈庆军. 跟骨锁定钢板与克氏针张力带治疗髌骨骨折的病例对照研究. 中国骨伤, 2018, 31(10): 889-893.
44. Holy F, Licano J, Treme G. Patellar fracture after ACL reconstruction: open reduction and internal fixation with a maxillofacial plate: a case report. JBJS Case Connect, 2021, 11(2). doi: 10.2106/JBJS.CC.20.00732.
45. 罗朝松, 曾东, 严超, 等. 垂直钢丝结合微型钢板治疗髌骨下极骨折. 骨科, 2021, 12(2): 170-172.
46. Hargett DI, Sanderson BR, Little MTM. Patella fractures: approach to treatment. J Am Acad Orthop Surg, 2021, 29(6): 244-253.
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