Analysis Of Curative Effect In The Treatment Of Patella Transverse Fracture With AO Kirschner Wire Tension Band And Cannulated Screws Tension Ban

Background: Currently, there is a variety of operation means for treating patellarfracture, including AO tension band fixation, cannulated screw tension band fixation,wire cerclage surgery, and memory alloy patella internal fixation.However,clinicaloutcomes vary among different ways.How to choose the effective, simple and feasibleoperation mean,depending on the type of fracture and current medical conditions, is stillan important issue that need to be addressed in clinical work.Objective: To provide foundation for doctors when choose the best operation wayfor patellar fracture by comparing clinical efficacy of the two surgical methods used inour hospital (cannulated screw tension band fixation and AO tension band fixation).Methods: Data from57cases of patellar fracture patients who were treated in thedepartment of orthopedics of the Second Affiliated Hospital of Dalian MedicalUniversity from October2010to October2012was collected.All the patients weredivided into two groups: those who received fracture open reduction and cannulatedscrew tension band fixation were classified to group A (n=22); and those whoreceived line fracture open reduction and AO tension band fixation were classified togroup B(35cases).All patients received the same postoperative treatments,including therational use of antibiotics, and pain symptomatic treatment.57patients were followed upfor an average of8.5months.All the follow-up data from the two groups werestatistically analyze in the following aspects: the cost of the surgery,the starting time ofthe postoperative functional exercise,the starting time of the fracture healing and theincidence of complications (nonunion, screw back, implant loosening, fracture and skinirritation).Result: Comparing the AO K-wire tension band internal fixation group (K-wiregroup) and cannulated screw tension band group (cannulated screw group), K-wire group was found to be shorter than the cannulated screw group in terms of meanoperating time required by the treatment, yet the cannulated screw group wassignificantly earlier than K-wire group for postoperative knee joint training time; also,the cannulated screw group presented a lower incidence of postoperative complicationsand much superior long-term postoperative clinical efficacy on patients, but muchhigher in mean operation costs required. These observation indicators showedstatistically significant differences (P <0.05).Conclusions: Seen from the research statistics, in the clinical practice of patellatransverse fracture treatment, the operation duration of cannulated screw tension bandinternal fixation is found to be longer than AO K-wire tension band internal fixation,along with a higher operation costs; whereas, the patients treated with the cannulatedscrew tension band internal fixation would be allowed for knee-joint flexion andextension training much earlier, showing relatively lower incidence of postoperativecomplications and better long-term clinical efficacy. Therefore, it can be widelypopularized in clinical works.