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Two methods of internal fixation in elderly patients with fracture of the patella compared

Of: Tang Shang-Quan, YANG Shuhua, Li Jian, Tang of the government [Abstract] Objective To compare the two elderly patients with patellar fracture fixation methods. Methods A retrospective analysis from January 1996 ~ December 2004 in our hospital by two internal fixation of patellar fractures in elderly 76 cases, of which internal fixation with tension band 42 cases, the use of nickel-titanium shape memory embracing fixator 34 cases of internal fixation on the two operative time, surgical complications, postoperative recovery, the average total time of hospitalization and average hospital costs were compared. The results of the two groups in postoperative recovery and hospital costs was no significant difference in total time of postoperative complications and hospital stay were significantly different between. Conclusions based on cost - effectiveness analysis, confirmed that nickel-titanium shape memory embracing fixator and internal fixation of patellar fracture in elderly patients than in patients with tension band fixation has more significant advantages. [Key words] patella; fracture; internal fixation device; complications: older Comparative study of different internal fixation for fracture of patella of elderly patients [Abstract] Objective To compare two internal fixations for fracture of patella of old patients.Methods From January 1996 to December 2004, we retrospectively evaluated fracture of patella of 76 old patients. Forty two patients in group A was treated with tension band wiring.Thirty four patients in group B was treated with Nickel-.Tilanium memory alloy patella concentrator, we analysed operation time, complications, total medical cost, total hospitalized time and the therapeutic effect of two groups.Results No significant difference were found in associated operation time, the therapeutic effect and total medical cost between two groups.There is less complications and total hospitalized time in group B than group A. Conclusion This study demonstrated that internal fixation with Nickel-.Tilanium memory alloy patella concentrator is more efficient method than with tension band wiring. [Key words] patella; fracture; internal fixators; complication; elderly traumatic patella fracture is the most common bone fracture of the joints, surgical treatment of multiple use as possible to achieve anatomical reduction in order to restore good function, reduce the incidence of traumatic arthritis of the likelihood and extent. As is often associated with age-related fracture more serious medical disease and osteoporosis, its treatment has always been a problem for orthopedics. How to simplify the operation and reduce the trauma is the treatment of senile fractures of the important tasks. Retrospective analysis of the author in January 1996 ~ December 2004 in our hospital aged 76 cases of patellar fracture, are as follows. 1 Materials and methods 1.1 General Information of this group 76 patients, male 55, female 21 cases; aged 60 to 74 years, mean 67.53 years. Cause of his injuries: 31 cases of car accidents, falls in 37 cases, 8 cases of heavy injured. There are 38 cases of 76 patients with combined and other trauma, including 13 cases of open fractures. With 57 cases of diabetes mellitus, hypertension, heart disease, chronic obstructive pulmonary disease, paralysis in one or several internal diseases. Follow-up time: 6 to 18 months, an average of 11.6 months. 76 patients were divided into two groups according to surgical approach, two groups of gender (χ2 = 0.042, P> 0.05), the age (χ2 = 0.013, P> 0.05) and complications of areas (χ2 = 0.71, P> 0.05) difference was not statistically significant, comparable, see Table 1. Basic situation of the two groups Table 1 Comparison 1.2 case inclusion criteria, analysis and description of patient's age must be greater than 60 years, no surgery and nickel-titanium shape memory embracing fixator removal were not included in this analysis. The operation time of two groups of patients, surgical complications, postoperative recovery and hospital costs, total hospitalization time were compared. Line tension band fixation include two hospital costs, length of stay of patients in which I and one accompanying person may create value to the local average wage level of 1,200 yuan / month basis, the average hospital costs and statistics. Traffic accident or other disputes rather than clinical need to extend the length of hospital stay and related costs (stitches wound healing occurred after 2 days of the time and costs) are excluded. 1.3 combined treatment of surgical wounds in the stable, while adjusting to the medical basis of disease can tolerate surgery after surgery, 76 cases of epidural anesthesia are used in pneumatic tourniquets carried by vertical knee curved arc incision or transverse incision. A group of 42 cases in which use of tension band fixation, the fracture reduction clamp after the temporary fixation with a towel, after the exploration formation of the articular surface, drill into the two longitudinal Kirschner wire, Kirschner wire parallel to the surface as far as possible with the patellar , as appropriate, plus a serious crush fracture of a transverse Kirschner wire used, and then around the Kirschner wire to form soft to repair the joint capsule, sutured. B group, 34 cases were surrounded by a nickel-titanium shape memory fixation device, the fracture reduction, smooth articular surface exploration, the use of towel clips temporarily fixed with 7 # silk suture and the suture ring before patellar aponeurosis,babyliss lockenstab, select the appropriate embracing fixator According to the patellar branch of the width of the end of functional claw end of the patellar ligament Reattachment Department, longitudinal symmetry of about 1 cm 2 cut a small incision, the device is set surrounded by salt water 0 ~ 5 ℃ for about 5 min, using special equipment Zhang open arms, embracing fixator, 0.3 ~ 0.5 cm from the patella to patellar sharp claws at the branch into the patellar ligament, patellar symmetry hold the hook tip, and then the end of the patellar ligament into the function of claw sticks and a small incision at the end of embedded patellar bone, 40 ℃ ~ 45 ℃ with the temperature and saline gauze cover, wait for step fracture, suture incision patellar tendon at the end, the repair of articular capsule sutured. After two methods were not plaster external fixation, joint activities after 1 days, the world of bed after 3, severe fractures may be extended for bed time. The group of tension band fixation fixation caught out, an average of 10.5 months after removal of internal fixation.