Analysis of reasons for internal fixation failure after internal fixation of patella fracture with nickel-titanium memory alloy patella claw and its countermeasures_West China Medical Journal

Authors：

LIANG Haisong ¹ , DENG Yu ¹ ,  HUI Xiaosu ² , BAI Xinwen ¹ , SHENG Dong ¹ , JIANG Renjian ³

1. Second Orthopedic Ward, Chongqing Orthopedic Hospital of Traditional Chinese Medicine, Chongqing 400010, P. R. China;
2. Department of Anorectal, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400000, P. R. China;
3. Department of Orthopedics, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400000, P. R. China;

Corresponding?author：

HUI Xiaosu, Email: 514608953@qq.com

Keywords：

Patellar fracture; Patella claw; Internal fixation failure

DOI：

10.7507/1002-0179.202006102

Video：

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Objective To analyze the reasons for internal fixation failure after internal fixation of nickel-titanium memory alloy patella claw for patella fracture, and to explore the countermeasures. Methods The clinical data of patients with patellar fracture treated by internal fixation of nickel-titanium memory alloy patella claw in the Second Orthopedic Ward of Chongqing Orthopedic Hospital of Traditional Chinese Medicine from May 2015 to April 2020 were analyzed retrospectively. Patients with postoperative internal fixation failure were identified. The reasons for internal fixation failure were analyzed. Results A total of 436 patients were included. Internal fixation failure occurred in 10 patients. There were 6 cases (1.38%) of patellar claw detachment, and 4 cases of simple fracture block displacement witharticular surface displacement≥2 mm (0.92%). Internal fixation failure occurred 4 to 48 days postoperatively, with an average of (18.20±10.86)days. The analysis showed that the reason for internal fixation failure in 4 patients was improper early postoperative functional exercise. The reason for 3 patients was that the auxiliary internal fixation was not selected. The reason for 2 patients was that the size of the patellar claw was too small. The reason for 1 patient was the improper fixation of the auxiliary internal fixation. Conclusion The failure of internal fixation after patella fracture with nickel-titanium memory alloy patella claw is mainly related to whether the model of the patella claw is appropriate, whether the auxiliary internal fixation is selected, whether the auxiliary internal fixation is properly fixed, and whether the early postoperative functional exercise is appropriate.

Citation： LIANG Haisong, DENG Yu, HUI Xiaosu, BAI Xinwen, SHENG Dong, JIANG Renjian. Analysis of reasons for internal fixation failure after internal fixation of patella fracture with nickel-titanium memory alloy patella claw and its countermeasures. West China Medical Journal, 2021, 36(10): 1361-1365. doi: 10.7507/1002-0179.202006102 Copy

1.	Kadar A, Sherman H, Drexler M, et al. Anchor suture fixation of distal pole fractures of patella: twenty seven cases and comparison to partial patellectomy. Int Orthop, 2016, 40(1): 149-154.
2.	Dickens AJ, Salas C, Rise L, et al. Titanium mesh as a low-profile alternative for tension-band augmentation in patella fracture fixation: a biomechanical study. Injury, 2015, 46(6): 1001-1006.
3.	戴傳強, 李躍輝, 肖堯. 記憶合金髕骨爪治療髕骨骨折失敗原因分析. 四川醫學, 2013, 34(12): 1888-1890.
4.	唐正標, 張成安, 劉建, 等. 鎳鈦記憶合金髕骨爪的材料學特點與髕骨骨折術后效果的關系. 中國組織工程研究與臨床康復, 2007, 11(9): 1771.
5.	黎介壽, 吳孟超. 手術學全集(矯形外科卷). 北京: 人民軍醫出版社, 1996.
6.	桂柯科, 尹望平, 俞永林. 鎳鈦形態記憶合金聚髕器治療粉碎性髕骨骨折. 復旦學報(醫學版), 2011, 38(3): 247-250.
7.	張釗, 徐世明, 向茜, 等. 兩種內固定方法治療髕骨下極骨折臨床療效的對比分析. 中國骨與關節雜志, 2019, 8(3): 220-224.
8.	劉欣偉, 蘇佳燦, 張春才, 等. 生理性成骨力值概念在鎳鈦聚髕器置入治療髕骨骨折的應用: 106例回顧. 中國組織工程研究與臨床康復, 2008(17): 3225-3228.
9.	王成潤, 楊小龍. 記憶合金聚髕器聯合可吸收線內固定治療粉碎性髕骨骨折. 中國骨與關節損傷雜志, 2015, 30(10): 1039.
10.	曲連軍, 李忠, 劉學勝, 等. 可分離式髕骨爪治療髕骨粉碎性骨折. 中國骨與關節損傷雜志, 2009, 24(3): 252-253.
11.	Du D, Wu Z, Xing J, et al. Finite element analysis of mechanics property on memory alloy patella claws with anti-shearing force. Appl Mech Mater, 2014: 507-510.
12.	喻永新, 陳曙輝, 肖彥, 等. 髕骨骨折記憶合金環抱器手術失敗原因探討. 醫學信息, 2009, 22(10): 1330-1332.
13.	耿震, 林永杰, 王國偉, 等. 帶線錨釘結合髕骨爪治療髕骨下極骨折. 中國矯形外科雜志, 2019, 27(14): 1330-1332.
14.	夏淑文, 黃國平. 克氏針聯合鎳鈦記憶合金髕骨爪內固定治療髕骨粉碎性骨折. 江西醫藥, 2017, 52(10): 1002-1003.
15.	余專一, 周江軍, 趙敏, 等. 髕骨爪結合克氏針張力帶治療髕骨下極粉碎性骨折. 中華關節外科雜志(電子版), 2018, 12(2): 280-283.
16.	夏濤. 記憶合金髕骨爪內固定治療復雜性粉碎性髕骨骨折的療效分析. 實用臨床醫藥雜志, 2018, 22(21): 82-85.
17.	黃東紅, 盧啟貴, 李長樹, 等. 聚髕器聯合克氏針內固定治療髕骨骨折. 中國中醫骨傷科雜志, 2016, 24(5): 71-73.

1. Kadar A, Sherman H, Drexler M, et al. Anchor suture fixation of distal pole fractures of patella: twenty seven cases and comparison to partial patellectomy. Int Orthop, 2016, 40(1): 149-154.
2. Dickens AJ, Salas C, Rise L, et al. Titanium mesh as a low-profile alternative for tension-band augmentation in patella fracture fixation: a biomechanical study. Injury, 2015, 46(6): 1001-1006.
3. 戴傳強, 李躍輝, 肖堯. 記憶合金髕骨爪治療髕骨骨折失敗原因分析. 四川醫學, 2013, 34(12): 1888-1890.
4. 唐正標, 張成安, 劉建, 等. 鎳鈦記憶合金髕骨爪的材料學特點與髕骨骨折術后效果的關系. 中國組織工程研究與臨床康復, 2007, 11(9): 1771.
5. 黎介壽, 吳孟超. 手術學全集(矯形外科卷). 北京: 人民軍醫出版社, 1996.
6. 桂柯科, 尹望平, 俞永林. 鎳鈦形態記憶合金聚髕器治療粉碎性髕骨骨折. 復旦學報(醫學版), 2011, 38(3): 247-250.
7. 張釗, 徐世明, 向茜, 等. 兩種內固定方法治療髕骨下極骨折臨床療效的對比分析. 中國骨與關節雜志, 2019, 8(3): 220-224.
8. 劉欣偉, 蘇佳燦, 張春才, 等. 生理性成骨力值概念在鎳鈦聚髕器置入治療髕骨骨折的應用: 106例回顧. 中國組織工程研究與臨床康復, 2008(17): 3225-3228.
9. 王成潤, 楊小龍. 記憶合金聚髕器聯合可吸收線內固定治療粉碎性髕骨骨折. 中國骨與關節損傷雜志, 2015, 30(10): 1039.
10. 曲連軍, 李忠, 劉學勝, 等. 可分離式髕骨爪治療髕骨粉碎性骨折. 中國骨與關節損傷雜志, 2009, 24(3): 252-253.
11. Du D, Wu Z, Xing J, et al. Finite element analysis of mechanics property on memory alloy patella claws with anti-shearing force. Appl Mech Mater, 2014: 507-510.
12. 喻永新, 陳曙輝, 肖彥, 等. 髕骨骨折記憶合金環抱器手術失敗原因探討. 醫學信息, 2009, 22(10): 1330-1332.
13. 耿震, 林永杰, 王國偉, 等. 帶線錨釘結合髕骨爪治療髕骨下極骨折. 中國矯形外科雜志, 2019, 27(14): 1330-1332.
14. 夏淑文, 黃國平. 克氏針聯合鎳鈦記憶合金髕骨爪內固定治療髕骨粉碎性骨折. 江西醫藥, 2017, 52(10): 1002-1003.
15. 余專一, 周江軍, 趙敏, 等. 髕骨爪結合克氏針張力帶治療髕骨下極粉碎性骨折. 中華關節外科雜志(電子版), 2018, 12(2): 280-283.
16. 夏濤. 記憶合金髕骨爪內固定治療復雜性粉碎性髕骨骨折的療效分析. 實用臨床醫藥雜志, 2018, 22(21): 82-85.
17. 黃東紅, 盧啟貴, 李長樹, 等. 聚髕器聯合克氏針內固定治療髕骨骨折. 中國中醫骨傷科雜志, 2016, 24(5): 71-73.

West China Medical Journal

Analysis of reasons for internal fixation failure after internal fixation of patella fracture with nickel-titanium memory alloy patella claw and its countermeasures

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