Objective To explore the surgical method and cl inical short-term outcomes of internal fixation combined closed reduction with arthroscope aid in treating patellar fracture. Methods From June 2004 to July 2008, 42 patients with fresh simple patellar fracture underwent internal fixation combined closed reduction with arthroscope aid, included28 males and 14 females, aged 16-59 years (35 years on average). The locations were 19 left knees and 23 right knees. Injury was by traffic accident in 21 cases, by fall ing in 11 cases, by sports in 7 cases and by crush in 3 cases. All the patients had fresh closed fracture, including 38 cases of transverse fracture and 4 cases of stellate fracture. The Lysholm score was 68.60 ± 15.20; the proprioceptive function of the knee joints was (3.72 ± 0.12)°. The time from injury to operation was 3-42 hours (12 hours on average). After the treatment of affil iated injury under the arthroscope, patellar fracture was reduced with manipulation method, fracture was fixed with tensile force screw or modified tension band. Results All incisions obtained heal ing by first intention after operation, 42 patients were followed up for 12-39 months (16 months on average). The X-ray films showed callus at the fracture and the smooth cartilage surface 6-9 weeks (7 weeks on average) after operation. The flexed motion range of knee joint at last follow-up was at normal range in 38 cases, was l imited in 4 cases. Circumference of suffered l imbs 15 cm above the patella was the same as normal ones in 23 cases, atrophied 0.7 cm in 19 cases. There were no breakage of internal fixation and shift of fracture and patellofemoral arthritis at last follow-up. The proprioceptive function of the knee joints was (2.06 ± 0.11)° and the Lysholm score was 95.10 ± 3.92; all showing statistically significant differences when compared with preoperation (P lt; 0.05). Conclusion This treatment method has advantages as follows: mini-wound, early exercises and few compl ications, which can rinse articular cavity and repair the affil iated injury at the same time.
Objective To investigate the clinical effect of chitosan in prevention of knee dysfunction due to adhesion after operation for patellar fracture. Methods From March to October 1999, 40 cases of patellar fracturewere treated by internal fixation, with intraarticular injection of 2% chitosan in only 24 cases after fixation and with no chitosan injection in 16 cases(control group). The function of the knee joint, including extension and flexion, was evaluated 1month and 1 year after operation respectively. Results One month after operation, the knees with chitosan injection could actively move in the average range of 104°±23°, and the knees in the control group could move in the average range of72°±16°, which showed significant difference between two groups(P＜0.01); 1 year after operation, the range of movement of the knees with injection was 165°±38° on average, and that of the knees in the control group was 110°± 31°, which also indicated significant difference between two groups (P＜0.05). Conclusion Medical chitosan could effectively prevent or reduce the post-operative adhesion of knee joint after patellar operation.
OBJECTIVE To evaluate the results of free auto-periosteal graft in primary repair of cartilage defect accompanying severe comminuted fractured of patella. METHODS From January 1992 to August 1998, seventeen cases with extensive cartilage defect due to severe comminuted fracture of patella were primarily repaired with free auto-periosteal graft. In these cases, there were whole patellar fracture in 9 patients, upper two third patellar fracture in 3 patients and lower two third patellar fracture in 5 patients. During operation, "S"-shaped incision along medial side of knee through intra-cavity pathway were used. After fixation of the patellar fracture and clearance of the residual cartilage in the fracture area, the cancellous bone was exposed and trimmed. The free periosteum was incised from the anterior medial side of upper tibia and then transplanted to the region of cartilage defect. The size of grafted periosteum ranged from 3 cm x 4 cm 5 cm 6 x cm. The knee joint was received passive motion at 7 days after operation. RESULTS All cases were followed up 8 to 74 months. There were excellent recovery in 12 patients and the function of knee joint was normal, better recovery in 4 patients and the function of knee joint was nearly normal, and moderate recovery in 1 patient and the function of knee joint was limited mildly. CONCLUSION Free auto-periosteal graft is a simple and effective treatment in primary repair of cartilage defect accompanying patellar fracture. It is valuable to apply in clinical practice.
In the study of the efficacy of internal fixation with tension band of musculofascial tendon in the treatment of fracture of patella, 52 cases were reported. After a following-up of 6 months to 13 months the bone healing was observed, in 7.5 weeks in average, and the function of the knee joint had recovered to normal or almost normal. It was concluded that the treatment of fracture of patella by internal fixation with tension band from musculofascial tendon was a ideal and practicable method.
From August 1986 to October 1990, 34 cases of fractures of patella were treated by the self-designed spring Kirschner wire, in which, 25 cases were followed up for an average of 1.5 years. The excellentgood rate reached 88%. In comparing with the traditional method of treatment, it gave more secure fixation for fracture, without the need or only a short time of immobilization needed, short treatment course and satisfactory return of function.
目的 观察盐酸氨基葡萄糖胶囊在髌骨骨折内固定术后促进膝关节功能恢复及缓解患者疼痛等临床症状方面的疗效。 方法 选取2009年1月－2012年1月收治入院的髌骨横行骨折患者52例，采用随机数字表法将患者随机分为试验组以及对照组，其中试验组患者26例，对照组患者26例，两组患者的性别、年龄、病情等临床资料，差异无统计学意义（P＞0.05）,具有可比性。其中，对照组仅在术后进行康复锻炼，试验组术后给予盐酸氨基葡萄糖内服，连续服用3个月。根据术后2、6周，6、12个月随访记录中的膝关节功能评分（采用KSS评分）分析疗效。 结果 对照组和试验组在骨折愈合程度比较差异无统计学意义（P＞0.05），试验组的膝关节功能评分在早期与对照组差异无统计学意义（P＞0.05），但在第12个月的随访评分中，试验组患者膝关节功能评分较对照组差异具有统计学意义（P＜0.05）。 结论 盐酸氨基葡萄糖胶囊有利于髌骨骨折术后患者的功能恢复及疼痛症状的缓解。