Effect of arthroscopic-assisted minimally invasive percutaneous closed reduction in the treatment of non-severely comminuted patellar fractures(fragments ≤3 pieces)
WANG Haichuan SANG Yuantian
The First Department of Orthopedic Surgery,the Fifth People′s Hospital of Dalian City,Liaoning Province,Dalian 116023,China
Abstract：Objective To investigate the effect of arthroscopic-assisted minimally invasive percutaneous closed reduction in the treatment of non-severely comminuted patellar fractures (fragments ≤3 pieces).Methods A total of 56 patients with non-severe comminuted patella fractures (fragments ≤3 pieces) admitted to the Fifth People′s Hospital of Dalian City from May 2014 to May 2018 were selected as the research subjects for retrospective analysis.The patients were divided into an arthroscopic group (30 cases) and a percutaneous group (26 cases) based on different surgical methods.The patients in the arthroscopic group were treated with arthroscopic-assisted minimally invasive percutaneous closed reduction,and the patients in the percutaneous group were treated with minimally invasive percutaneous closed reduction under fluoroscope.They were both fixed with cannulated screws and titanium cable.The operation time,intraoperative fluoroscopic times,intraoperative blood loss,incision length,postoperative incision healing time,bone healing time were compared between the two groups.The total incidence of postoperative complications and the total incidence of postoperative comorbidity were compared between the two groups.According to the knee joint score of Hospital for Special Surgery in New York (HSS),the excellent rate and good rate of postoperative knee joint function in the two groups were investigated.Results There were no significant differences in operative time,intraoperative blood loss,incision length,postoperative incision healing time and bone healing time between the two groups (P>0.05).The number of intraoperative fluoroscopy in arthroscopy group was less than that in percutaneous group,and the difference was statistically significant (P<0.05).The total incidence rates of postoperative complications and postoperative comorbidity in arthroscopy group were lower than those in percutaneous group,with statistical significances (P<0.05).There were no significant differences in the excellent rate and good rate of knee function between the two groups (P>0.05).Conclusion Arthroscopic-assisted minimally invasive percutaneous closed reduction and minimally invasive percutaneous closed reduction under fluoroscope method can be used in the treatment of non-severely comminuted patellar fractures (fragments ≤3 pieces),but arthroscopic-assisted minimally invasive percutaneous closed reduction has fewer intraoperative fluoroscopy times and lower incidence of postoperative complications and comorbidity,which is recommended for clinical application.
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