To evaluate technical feasibility
and clinical outcome of the arthroscopy assisted reduction and
percutaneous cannulated screw tension band internal fixation for the
treatment of comminuted patellar fractures.
From August 2010 to May 2016, 48 patients with comminuted patellar fracture were included into this study. Of them, 27 patients had the comminuted patella fracture treated by arthroscopy assisted reduction and internal fixation with percutaneous cannulated screw tension band (the arthroscopy group) , while the other 21 patients underwent traditional open reduction and internal fixation (the ORIF group) . The operation time, incision length, frequency of intraoperative fluoroscopy used, fracture healing time and postoperative complication were recorded, additionally, Lysholm score, HSS score and Xu??s comprehensive grade were used for evaluation of the consequences.
Although no a statistical difference was noted in operation time
between the two groups (P>0.05) , the arthroscopy group had
significantly smaller incision and less frequency of fluoroscopy used
than the ORIF group (P<0.05) . No early complications, such as wound
infection and neurovascular injury occurred in any patient of both
groups. All the patients in the two groups were followed up for 7 to 46
months with an average of 20 months. The arthroscopy group took
considerably less time for bone healing than the ORIF group (P<0.05) .
In addition, the arthroscopy groups was statistically superior to the
ORIF group in Lysholm score at 6 months and HSS score at 1 year after
operation (P<0.05) . In term of Xu,s scale, the results were graded
as excellent and good in 100% patients of the arthroscopy group, whereas
85.7% patients of the ORIF group. No late complications, such as
nonunion and implant loosening happened in any of them. Conclusion
Arthroscopy assisted reduction and percutaneous cannulated screw tension band internal fixation for the treatment of comminuted patellar fractures with advantage of accurate reduction of the articular surface and small incision, facilitate early rehabilitation and function recorvery.