The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole, in combination with patellar concentrator: a retrospective comparative study
Abstract Objective The patellar inferior pole fracture is typically comminuted. Hence, achieving firm fixation and early activity is highly challenging. In this article, we employed the method of wire cerclage through a generated bone hole to reduce the fracture. Our objective was to compare the cli...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-02-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03014-7 |
| _version_ | 1828118016015990784 |
|---|---|
| author | Rong Chen Hong Cao Zhibo Sun Liangbo Jiang Xiangwei Li Lin Zhao Xinghui Liu |
| author_facet | Rong Chen Hong Cao Zhibo Sun Liangbo Jiang Xiangwei Li Lin Zhao Xinghui Liu |
| author_sort | Rong Chen |
| collection | DOAJ |
| description | Abstract Objective The patellar inferior pole fracture is typically comminuted. Hence, achieving firm fixation and early activity is highly challenging. In this article, we employed the method of wire cerclage through a generated bone hole to reduce the fracture. Our objective was to compare the clinical efficacy of patellar concentrator alone with a combination of cerclage and patellar concentrator in the treatment of patellar inferior pole fracture. Methods We conducted a retrospective review of patients with patellar inferior pole fractures, who underwent patellar concentrator fixation only (the control group) or cerclage combined with patellar concentrator fixation (the experimental group), performed by a single surgeon, between July 2015 and October 2019. Our analysis included surgical indexes like7 aspects (fracture gap after operation, operation time, intra-operative blood loss, intra-operative number of C-arm fluoroscopies conducted, Insall–Salvati ratio calculated immediately after operation, initial range of motion on the 7th day after operation, and fracture healing time), as well as the Bostman score and complications recorded on 1-, 3-, 6-, and 12-month follow up post operation. Results A total of 94 patients with patellar inferior pole fracture and a minimum 1-year follow up were recruited. Following operation, the control group had 33 (71.74%) patients with a fracture gap of 0–2 mm and 13 (28.26%) patients with a fracture gap greater than 2 mm (P = 0.002). Conversely, the experimental group had 46 (95.83%) patients with a fracture gap of 0–2 mm and 2 (4.17%) patients with a fracture gap greater than 2 mm (P = 0.002). Compared to the control group, the experimental group did not experience enhanced operation time or intra-operative blood loss (P = 0.811, P = 0.823). The Insall–Salvati ratio and initial range of motion in the experimental group were larger than the control group (P = 0.037, P = 0.000). Alternately, the number of intra-operative C-arm fluoroscopies conducted and fracture healing time of the experimental group were considerably less than the control group (P = 0.003, P = 0.000). Moreover, at 1-, 3-, 6-, and 12-month follow ups after operation, the Bostman scores of the experimental group were remarkably higher than the control group (P < 0.05). At 12 months post operation, 23 cases (50%) were classified as excellent, 22 cases (47.83%) were good, and 1 case (2.17%) was poor in the control group (P = 0.005). In the meantime, in the experimental group, 38 cases (79.17%) were deemed as excellent and 10 cases (20.83%) were good (P = 0.005). Lastly, complications were detected in 3 cases (6.52%; 1 case of internal fixation loss, 2 cases of hematoma) within the control group, and in 1 case(2.08%; marginal wound necrosis) within the experimental group. There was no wound infection, implant discomfort, or broken fixation in either group. Conclusion Managing the patellar inferior pole fracture with wire cerclage through a generated bone hole is both simple and effective. Moreover, an additional step of patellar concentrator fixation facilitates early functional exercise, with satisfactory clinical outcome. |
| first_indexed | 2024-04-11T13:24:31Z |
| format | Article |
| id | doaj.art-484bc787155e40df913f32e6dc22ba27 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:24:31Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-484bc787155e40df913f32e6dc22ba272022-12-22T04:22:06ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-02-0117111010.1186/s13018-022-03014-7The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole, in combination with patellar concentrator: a retrospective comparative studyRong Chen0Hong Cao1Zhibo Sun2Liangbo Jiang3Xiangwei Li4Lin Zhao5Xinghui Liu6Department of Traumatic Orthopedics, Renmin Hospital, Hubei University of MedicineDepartment of Traumatic Orthopedics, Renmin Hospital, Hubei University of MedicineDepartment of Traumatic Orthopedics, Renmin Hospital, Hubei University of MedicineDepartment of Traumatic Orthopedics, Renmin Hospital, Hubei University of MedicineDepartment of Traumatic Orthopedics, Renmin Hospital, Hubei University of MedicineDepartment of Traumatic Orthopedics, Renmin Hospital, Hubei University of MedicineDepartment of Traumatic Orthopedics, Renmin Hospital, Hubei University of MedicineAbstract Objective The patellar inferior pole fracture is typically comminuted. Hence, achieving firm fixation and early activity is highly challenging. In this article, we employed the method of wire cerclage through a generated bone hole to reduce the fracture. Our objective was to compare the clinical efficacy of patellar concentrator alone with a combination of cerclage and patellar concentrator in the treatment of patellar inferior pole fracture. Methods We conducted a retrospective review of patients with patellar inferior pole fractures, who underwent patellar concentrator fixation only (the control group) or cerclage combined with patellar concentrator fixation (the experimental group), performed by a single surgeon, between July 2015 and October 2019. Our analysis included surgical indexes like7 aspects (fracture gap after operation, operation time, intra-operative blood loss, intra-operative number of C-arm fluoroscopies conducted, Insall–Salvati ratio calculated immediately after operation, initial range of motion on the 7th day after operation, and fracture healing time), as well as the Bostman score and complications recorded on 1-, 3-, 6-, and 12-month follow up post operation. Results A total of 94 patients with patellar inferior pole fracture and a minimum 1-year follow up were recruited. Following operation, the control group had 33 (71.74%) patients with a fracture gap of 0–2 mm and 13 (28.26%) patients with a fracture gap greater than 2 mm (P = 0.002). Conversely, the experimental group had 46 (95.83%) patients with a fracture gap of 0–2 mm and 2 (4.17%) patients with a fracture gap greater than 2 mm (P = 0.002). Compared to the control group, the experimental group did not experience enhanced operation time or intra-operative blood loss (P = 0.811, P = 0.823). The Insall–Salvati ratio and initial range of motion in the experimental group were larger than the control group (P = 0.037, P = 0.000). Alternately, the number of intra-operative C-arm fluoroscopies conducted and fracture healing time of the experimental group were considerably less than the control group (P = 0.003, P = 0.000). Moreover, at 1-, 3-, 6-, and 12-month follow ups after operation, the Bostman scores of the experimental group were remarkably higher than the control group (P < 0.05). At 12 months post operation, 23 cases (50%) were classified as excellent, 22 cases (47.83%) were good, and 1 case (2.17%) was poor in the control group (P = 0.005). In the meantime, in the experimental group, 38 cases (79.17%) were deemed as excellent and 10 cases (20.83%) were good (P = 0.005). Lastly, complications were detected in 3 cases (6.52%; 1 case of internal fixation loss, 2 cases of hematoma) within the control group, and in 1 case(2.08%; marginal wound necrosis) within the experimental group. There was no wound infection, implant discomfort, or broken fixation in either group. Conclusion Managing the patellar inferior pole fracture with wire cerclage through a generated bone hole is both simple and effective. Moreover, an additional step of patellar concentrator fixation facilitates early functional exercise, with satisfactory clinical outcome.https://doi.org/10.1186/s13018-022-03014-7Patellar inferior pole fracturePatellar concentratorFracture reductionCerclage |
| spellingShingle | Rong Chen Hong Cao Zhibo Sun Liangbo Jiang Xiangwei Li Lin Zhao Xinghui Liu The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole, in combination with patellar concentrator: a retrospective comparative study Journal of Orthopaedic Surgery and Research Patellar inferior pole fracture Patellar concentrator Fracture reduction Cerclage |
| title | The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole, in combination with patellar concentrator: a retrospective comparative study |
| title_full | The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole, in combination with patellar concentrator: a retrospective comparative study |
| title_fullStr | The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole, in combination with patellar concentrator: a retrospective comparative study |
| title_full_unstemmed | The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole, in combination with patellar concentrator: a retrospective comparative study |
| title_short | The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole, in combination with patellar concentrator: a retrospective comparative study |
| title_sort | clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole in combination with patellar concentrator a retrospective comparative study |
| topic | Patellar inferior pole fracture Patellar concentrator Fracture reduction Cerclage |
| url | https://doi.org/10.1186/s13018-022-03014-7 |
| work_keys_str_mv | AT rongchen theclinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT hongcao theclinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT zhibosun theclinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT liangbojiang theclinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT xiangweili theclinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT linzhao theclinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT xinghuiliu theclinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT rongchen clinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT hongcao clinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT zhibosun clinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT liangbojiang clinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT xiangweili clinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT linzhao clinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy AT xinghuiliu clinicaloutcomeofthereductionofthepatellarinferiorpolefracturewithwirecerclagethroughageneratedboneholeincombinationwithpatellarconcentratoraretrospectivecomparativestudy |