Biomechanical Study And Its Clinical Significane Of Five-pointed Star Lattice Sutures In Treatment Of Patella Fractures

Objective:The aim of this article is to find out the biomechanical characters and curative effects of the clinical application of five-pointed star lattice sutures ' techniques applied in internal fixation for patellar fractures, by comparing the internal fixation techniques of Kirschner wires tension band with wire for patellar fractures, through biomechanical tests and observing the follow-up visit results in clinic.And then, for the future treatment of patella fracture to provide a simple, consistent with biological fracture mechanics fixation, the early activities of the knee, functional recovery, and do not need the second surgery within a fixed procedure.Methods:1.The 20 rear limbs of 10 fresh corpses from cattle were obtained,whose patellas were cut into two pieces with the Saw pendulum at the middle points to form the models of patellar transverse fractures which were then divided into two groups randomly and treated with five-pointed star lattice sutures or Kirschner wires tension band, to build up the biomechanical experimental animal models. We may obtain the corresponding separation distance of fracture end under a different load (0 to 500 N) through quadriceps loading test.2. The analyses of review were done for the 66 cases of suffers with patellar fractures treated by the techniques of five-pointed star lattice sutures and Kirschner wires tension bandResults:1. Based on 10 fresh bodies of 20 cattle patellar fractures caused hind limb model divided into two groups: five-pointed star lattice sutures and Kirschner wires tension band ,under (0 to 500 N) mechanical load tests , The capacity of anti-fatigue of five-pointed star lattice sutures ' was better than that of Kirschner wires tension band when the pulling force was 0～300N(P<0.05). There is no significant difference of patellar fracture separation distance betwe lattice sutures and Kirschner wires tension band (P>0.05) under 300to 500 N mechanical fatigue tests . We found there is no significant difference between them in the intensity and stability of these two methods of internal fixation.2. The follow-up visitation of 6 to 12 months(average 10.2 months) had been made on 66 patella fractures.According to the clinical of the knee joint surgery scoring systerm , we found that 30 cases were excellent;4 cases were good and 2 cases were middling, the excellent and good results were seen in 94.4% in five-pointed star lattice sutures;26 cases were excellent;3 cases were good and 1 case was bad.The excellent and good results were seen in 96.7% in Kirschner wires tension band . Comparison of the two groups had no significant difference (X2 = 0.026, P> 0.05).Conclusion :1. The techniques of five-pointed star lattice sutures applied on the internal fixation to patella fractures was tension band fixation which accords with the biomechanical principles and has preferable elasticity, which provides nicer stabilization in fixation on the fractured patellas and can resist stronger bending force and pulling force.2. There are many merits for internal fixation techniques of five-pointed star lattice sutures on patellar fractures, such as solid internal fixation, easily grasped operation techniques, less syndromes, etc. It is a kind of ideal new method for treating patellar fracture in clinic.