摘要
Abstract
Objective:To compare the effects of modified vertical wiring combined with wire cerclage internal fixation and wire tension band combined with mini-plate fixation on postoperative knee joint function and quality of life in patients with inferior patella fracture,and their influence in bone metabolism and pain mediators.Method:The clinical data of 99 patients with inferior patella fracture in Yingtan No.184 Hospital from June 2021 to December 2022 were retrospectively selected.According to different surgical methods,patients with inferior patella fracture who were internally fixed with modified vertical wires combined with wire cerclage internal fixation were selected as the observation group(50 cases),patients fixed with steel wire tension bands combined with mini-plates fixation were selected as the control group(49 cases).The two groups were followed up for 12 months,and the operation time,incision length,intraoperative blood loss,postoperative fracture healing and functional recovery(Böstman score,knee joint mobility),preoperative and postoperative VAS,and Barthel index,and bone metabolic markers[serum bone gla protein(BGP),bone alkaline phosphatase(BALP),periostin(POSTN)]and pain mediators levels[serum neuropeptide Y(NPY),prostaglandin E2(PGE2),substance P(SP),dopamine(DA)]at 3 months after operation in both groups were observed.There was no postoperative complication in both groups.Result:There were no statistically significant differences in the operation time,incision length,and intraoperative blood loss between the two groups(P>0.05);fracture healing and functional recovery:there was no statistical difference in postoperative fracture healing time between the two groups(P>0.05),the Böstman score of the observation group[(28.04±1.93)points]was higher than that of the control group[(25.53±2.45)points]12 months after operation(P<0.05),and the postoperative knee joint mobility gradually of the two groups were increased over time(P<0.05),and the knee joint mobility of the observation group were higher than those of the control group 1,3,6 months after surgery(P<0.05).The rate of knee joint function in the observation group being excellent was higher than that in the control group(P<0.05);pain score:there were no significant differences in VAS scores between the two groups before operation,3 days and 7 days after operation(P>0.05).On the 30th day after operation,VAS score in the observation group was lower than that in the control group(P<0.05).The Barthel index of the observation group was(82.53±10.29)points,which was higher than(70.16±8.45)points of the control group(P<0.001).30 days after surgery,the BGP,BALP,and POSTN levels of the observation group were higher than those of the control group,while NPY,PGE2,SP,and DA were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Modified vertical wiring combined with wire cerclage internal fixation and steel wire tension band combined with micro-plate fixation are safe and effective in treating inferior patella fracture,can regulate bone metabolism,inhibit pain mediators,improve the function of patients'knee joints and quality of life,but modified vertical wiring combined with wire cerclage internal fixation is better at improving knee joint function in patients with inferior patella fracture.关键词
髌骨下极骨折/改良垂直钢丝/钢丝环扎内固定Key words
Inferior patella fracture/Modified vertical wiring/Wire cerclage internal fixation
