| Objective: To compare the efficacy of SVHSS combined with Krackow suture and SVW combined with Krackow suture in the treatment of inferior patellar fractures.Methods: From January 2017 to January 2022,41 patients diagnosed with inferior pole patella fracture were collected and divided into SVHSS group(n=19)and the SVW group(n=16).The general data of patients in both groups were recorded,including patients’ gender,age,hospitalization time,time from trauma to surgery,hospitalization cost,postoperative follow-up time,and surgery time.Postoperative follow-up was performed with frontal and lateral knee X-ray or CT of the knee to evaluate fracture healing and internal fixation.Patients were followed up at 2 weeks,1 month,3 months,and 6 months after surgery and Bostman score,Lysholm score,HSS score,and maximum knee flexion were recorded to assess the recovery of knee function.The patient’s VAS was recorded to assess the improvement of postoperative pain.The modified Barthel score was recorded to assess the patient’s postoperative general living ability.Patients’ postoperative complications were recorded.The differences in general information and follow-up indicators between the two groups were compared using SPSS 26.0,and the differences were considered statistically significant when p<0.05.Results: Six patients out of 41 patients(19 in the SVHSS group and 16 in the SVW group)were lost to follow-up(a loss rate of 14.6%),and the remaining patients completed follow-up.The postoperative excellent rate was 100% in both groups according to the Bostman score standard.There was no significant difference between the two groups in terms of general information including gender,age,length of hospital stay,hospital cost,time from injury to surgery,postoperative follow-up,and time to surgery(p=0.364,p=0.795,p=0.714,p=0.502,p=1.000,p=0.291,p=0.850).Bone healing was achieved in all patients,including 18 patients in the SVHSS group at the 3-month postoperative follow-up and 1patient at the 4-month postoperative follow-up,and 15 patients in the SVW group at the 3-month postoperative follow-up and 1 patient at the 4-month postoperative follow-up.There was no significant difference in Bostman score between the two groups at 2 weeks postoperatively,1 month postoperatively and 3 months postoperatively(p=0.411,p=0.305,p=0.908),and the SVHSS group had better Bostman score than the SVW group at 6 months postoperatively,with a statistically significant difference between the two groups(p=0.027),and there was no significant difference in Bostman score between the two groups for the whole course of treatment difference(p=0.078).There was no significant difference in Lysholm scores between the two groups compared at each postoperative time point(p=0.128,p=0.004,p=0.964,p=0.769),and no significant difference in Lysholm scores between the two groups compared for the full course(f=2.330,p=0.136).There was no significant difference in the HSS scores at each postoperative time point comparing the two groups(p=0.110,p=0.961,p=0.816,p=0.753),and no significant difference in the HSS scores between the two groups comparing the full course(f=0.092,p=0.763).There was no significant difference in VAS scores between the two groups at each postoperative time point(p=0.113,p=0.246,p=0.174,p=0.367,p=0.285),and no significant difference in VAS scores between the two groups for the full course of treatment(f=3.867,p=0.058).There was no significant difference in the maximum knee flexion between the two groups at 3 months postoperatively and 6 months postoperatively(p=0.465,p=0.170),and there was no significant difference in the maximum knee flexion between the two groups for the whole course of treatment(f=1.279,p=0.266).There was no significant difference in the modified Barthel score between the two groups at 2 weeks and1 month postoperatively(p=0.482,p=0.248),and all patients obtained all Barthel scores at 3 months postoperatively.There was no significant difference between the two groups in the comparison of full course modified Barthel scores(f=1.116,p=0.299).There was no significant difference in the incidence of postoperative complications between the two groups(p=0.582).Conclusion: Both surgical approaches achieved reliable fixation and good clinical outcomes in the treatment of inferior patellar pole fractures.At the same time,SVHSS combined with Krackow suture has the potential advantage of eliminating the need for secondary surgery to remove the internal fixation and is a feasible way to treat inferior patellar pole fractures. |
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