A Retrospective Cohort Study On The Treatment Of Patellar Inferior Pole Fracture With Transosseous Tunnel Suture And Anchor Suture

Introduction:Patellar inferior pole fracture is not so easy to fix for the weakness of small comminuted distal fragments,And there are only several effective fixation methods to choose for the patients suffering from patellar inferior pole fracture,for most of them are metal internal fixation,the patient are often need a second operation to take out the device.The discomfort of hard material related and skin irritation,as well as failure of internal fixation often affect its clinical curative effect,which reduce the patient and clinician's choice to make from them.suture fixation technique for the treatment of patellar inferior pole fracture was reported and introduced in related study.With its unique advantages,the technique obtained good Clinical outcome and won the recognition of clinical physicians and patients.Transosseous tunnel suture(TTS)and suture anchor(AS)are commonly used in suture fixation technique,they have their own merits and limits,but so far there is no relevant literature made contrast research about them,so that the relative merits of them is uncertain.The aim of the present study was to evaluate and to compare the clinical outcomes of transosseous tunnel suture(TTS)and anchor suture(AS)for the fixation of patellar inferior pole fracture,hope to bring some reference to clinical practice.Methods:35 patellar inferior pole fracture patients,treated at trauma group of the second affiliated hospital of nanchang university from June 2014 to April 2018,were retrospectively reviewed;14 patients were treated with TTS technique and 21 patients were treated using AS fixation.The operation time,length of hospital stay,incision length,and total cost were collected and evaluated.Functional outcomes were evaluated with visual analogue scale(VAS),Bostman,Lysholm scores and knee joint ranges of motion(ROM).Post-operative complications were also observed and recorded,and the complications of the two groups were compared and analyzed.Results:Patients in TTS and AS groups were followed up for 22.6±9.7 months and18.7±5.9 months respectively(P>0.05).Two groups were similar for age,operative side,length of hospital stay,gender and time to surgery(P>0.05).The shorter operation time and smaller incision length but higher hospital costs were observed in the AS group(P < 0.01).There was no significant difference in either VAS,Bostman,Lysholm scores and ROM for function evaluation between the two groups groups(P >0.05).There were no significant postoperative complications in the TTS group.Only one patient in the AS group hapened poor superficial wound healing.Conclusions:The TTS and AS techniques can provides similar satisfactory clinical curative results for treating patellar inferior pole fracture.,and the complication rate of them is very low.The former has the advantage of cost effectiveness by saving anchors,while the latter provides less operation time with smaller incision length.Therefore,both TTS and AS techniques can provide good clinical results for the patellar inferior pole fracture.