改良垂直钢丝技术治疗髌骨下极骨折疗效分析

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Abstract Objective To investigate the clinical outcome of the modified vertical wire technique for the treatment of distal pole fracture of the patella.Methods A three-dimensional model of modified vertical wire for inferior pole fracture of the patella was established and then the biomechanical property of the modified technique was analyzed by finite element method.From March 2013 to January 2016，15 consecutive patients with distal pole fractures of the patella treated with modified independent vertical wire technique were enrolled in this study and then the operative parameters regarding operational time as well as incision length，postoperative complications and functional outcomes were assessed.Results In the clinical study，12 of 15 patients were followed up for 13～35 months，the mean follow-up period was (21.08±6.81)months and the mean incision length and operation time was(7.75±1.81) cm (6～12 cm) and (42.50±12.80) minutes (range，23～60 minutes).Incision infection，implant breakage，nonunion，and loss of reduction did not occur.One patient suffered loosening of the twisted knot of the cerclage wire at 8 months after operation.At the final follow-up，the mean Bostman score was (29.16±0.834) (28～30) and the average range of the knee motion arc was (131.25±3.1)°(125°～135°).Conclusion The modified independent vertical wire technique for the treatment of distal fracture of the patella is an effective，simple and minimally invasive surgery which can provide stable fixation for immediate postoperative extension and flexion exercise and early full weightbearing with lower cost of treatment and ultimately excellent functional results.

Key words： patellar inferior pole fracture separate vertical wiring

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