The Clinical Curative Effect Analysis Of AO Kirschner Wire Tension Band And NiTi-patella Concentrator On Treatment Of Patella Fractures

Patella, surrounded by the quadriceps tendonis,is the largest sesamoid of the human body. There are many functions, such as: protecting the articular surface of tibia and femoral condyle, composing of the extensor device with the femoral condyle, playing the role of leverage in the process of extension and maintaining the stability of the knee joint in the semi flexion position to avoid excessive internal or external turnover. Although people’s living standard was continuous improving and material resources were constantly enriching, the incidence of all kinds of accidents has been gradually increasing. Patellar fracture has become one of the common clinical diseases in the Department of orthopedics, which has attracted enough attention between the doctors and patients. Usually the direct or indirect violence still easily lead to the patella injury because of its superficial position,(only with skin, subcutaneous tissue and prepatellar bursa coveraging).The incidence of patellar fractures accounted for about 1.65% in all of the total other fractures. In recent years, with the continuous deepening of the clinical study on patellar fracture, in order to bring more convenience to patients(such as reducing expenses, relieving pain, shortening the recovery time after surgery,retaining the perfect function as far as possible),the methods of treatment are also gradually expanding and improving. The surgical methods were summarized as: Tension band fixation(AO tension band internal fixation, cerclage wire fixation, Cable-pin system), Ni Ti-patella concentrator internal fixation, absorbable tension band fixation(Five corner stitching mesh), external fixation, total patellar resection, partial patellar resection, etc. There are many methods for the treatment of patellar fracture. But the correct operation mode should be selected according to the type of patellar fracture. The best treatment options will be used for surgical treatment. After the operation, It is necessary to choose a reasonable combination treatment of Traditional Chinese Medicine according to different syndrome to achieve the best therapeutic effect and make contribution to the majority of patients much more better.Objective: The purpose of this study is to explore, compare and discuss the clinical efficacy of AO Kirschner wire tension band and Ni Ti-patella concentrator in the treatment of patellar fracture. Method:46 patients with patella fracture from Hubei Provincial Traditional Chinese Medical Hospital and Wuhan General Hospita of Guangzhou Military Region by retrospective analysis method were divided for two groups according to the inclusion and exclusion criteria by simple random sampling method during the period from January 2014 to September 2015. 20 patients in AO Kirschner wire tension band group(A group) receive the treatment of orif with AO Kirschner wire tension band, 26 patients in Ni Ti-patella concentrator group(B group) receive the treatment of orif with Ni Ti-patella concentrator. After surgery, the pain relief,antibiotics,CPM machine auxiliary function exercise, oral traditional Chinese medicine and Lotion for external use in Department of Traumatology sould be actively offered for symptomatic treatment. In the 7 nodes among the 0-2 days, 1 weeks, 2 weeks, 4 weeks, 6 weeks, 3 months, 1 years, all the patients should receive positive lateral and oblique radiographs of the knee joint. Finally, we made a comparative analysis among operation time of different methods, fracture healing time, postoperative complications and functional recovery of knee joint.Result: All the patients were followed up for 9-16 months, an average of 12 months.(1)There were significant differences between the two groups in operation time(P<0.05).The operation time of Ni Ti-patella concentrator group was shorter than that of AO Kirschner wire tension band group.(2)There was no significant difference in fracture healing time between the two groups(P>0.05).(3)The incidence of postoperative complications was higher in group A than in group B(P<0.05).(4)There was no significant difference between the two groups in the postoperative knee function recovery(P>0.05).Conclusion: AO Kirschner wire tension band and Ni Ti-patella concentrator are effective in the treatment of patellar fracture. There was no clear difference in fracture healing time and therapeutic effect. Ni Ti-patella concentrator has the advantages of more simple operation, Shorter operative time, lower incidence of internal fixation loosening, more obvious advantages in the treatment of complicated fracture types, more convenient and fast in the second operation of removing internal fixation. But AO Kirschner wire tension band was also full of excellent advantages in terms of price. Therefore, the choice of the two surgical methods have to be based on the actual situation.