Objective: To explore the feasibility and effectiveness of suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique for avulsion fractures of the inferior pole of the patella.
Methods: A clinical data of 38 patients with avulsion fractures of the inferior pole of the patella, who met the selective criteria and were admitted between September 2021 and April 2023, was retrospectively analyzed. The fractures were treated with suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique in 18 cases (group A) and steel wire tension-band fixation in 20 cases (group B). There was no significant difference in terms of age, gender, cause of fracture, side of fracture, and disease duration between the two groups ( P>0.05). The length of incision, operation time, occurrence of complications, the range of motion of knee joint, and Böstman score of knee joint at last follow-up were recorded. The fracture healing was evaluated through X-ray films and the time of fracture healing was recorded.
Results: All incisions healed by first intention. The length of incision was significantly shorter in group A than in group B ( P<0.05). There was no significant difference in the operation time between the two groups ( P>0.05). All patients were followed up 12-24 months (mean, 16.1 months). X-ray films showed that all fractures healed and there was no significant difference in the healing time between the two groups ( P>0.05). At last follow-up, the range of motion and Böstman score of the knee joint in group A were significantly better than those in group B ( P<0.05). During follow-up, 1 patient (5.6%) in group A had one anchor mild prolapse and 3 patients (15.0%) occured internal fixation irritation in group B. But there was no significant difference in the incidence of complications between the two groups ( P>0.05).
Conclusion: For the avulsion fractures of the inferior pole of the patella, the suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique has advantages of reliable fixation, small incision, avoidance of secondary operation to remove internal fixator, and fewer complications, with definite effectiveness.
目的: 探讨带线锚钉双滑轮结构联合缝线经骨隧道三维捆扎治疗髌骨下极撕脱性骨折的可行性与疗效。.
方法: 回顾分析2021年9月—2023年4月收治且符合选择标准的38例髌骨下极撕脱性骨折患者临床资料。其中，采用带线锚钉双滑轮结构联合缝线经骨隧道三维捆扎技术18例（A组），传统钢丝张力带固定技术20例（B组）。两组患者年龄、性别、骨折原因及侧别、病程等基线资料比较，差异均无统计学意义（ P>0.05）。记录并比较两组切口长度、手术时间、术后并发症发生情况，末次随访时患膝关节活动度、膝关节髌骨功能Böstman评分；采用X线片评估骨折愈合情况，记录骨折愈合时间。.
结果: 术后两组切口均Ⅰ期愈合。A组切口长度短于B组，差异有统计学意义（ P<0.05）；两组手术时间差异无统计学意义（ P>0.05）。两组患者均获随访，随访时间12～24个月，平均16.1个月。膝关节X线片复查示两组骨折均愈合且愈合时间差异无统计学意义（ P>0.05）。末次随访时，A组膝关节活动度及Böstman评分均优于B组（ P<0.05）。随访期间，A组发生1例（5.6%）1枚锚钉轻度脱出，B组3例（15.0%）内固定激惹，但两组并发症发生率差异无统计学意义（ P>0.05）。.
结论: 与传统钢丝张力带固定技术相比，带线锚钉双滑轮结构联合缝线经骨隧道三维捆扎技术治疗髌骨下极撕脱性骨折，具有固定可靠、切口小、能避免二次手术取出内固定物以及并发症少等优点，疗效确切。.
Keywords: Inferior pole fracture of patella; double-pulley technique; internal fixation; suture anchor; three-dimensional binding.