Patella Fractures chinfelna tur Surgical Modalities thar 3

Patellar fracture hi trauma case zawng zawng zinga 1% a ni a, tuna guideline-in articular surface displacement nei simple transverse patellar fracture enkawlna atana surgical procedure rawt chu tension band wire (TBW) a ni a, hei hian patellar (stretched) surface chu bending force a neih chuan antitension device angin a thawk a ni.

Mahse, he procedure avanga harsatna awm thei chu wire internal fixation failure, infection, leh wound dehiscence te hi a ni. Chu bakah, longitudinal wire hman hi a harsa hle thei a, a bik takin patellar tendon leh quadriceps tendon-a wire tawp chu clip leh phum a nih chuan.

Standard TBW ang chiah hian transverse patella fracture fixation atan technique thar 3 kan design a.

1. kerf pin-te cross-drive hnuah figure-of-eight wire tension band hman a ni.

2. longitudinal Kirschner pin leh tension band te chu patella sir lehlamah a awm a.

3. Kirschner pin leh lateral tension strap te chu a cross a.

Chuvangin, he biomechanical study hian a tum ber chu fixation method thar 3 chu AO gold standard of wire tension banding nen khaikhin a ni. 

Kan hypothesis hmasa ber chu crossed kerf pin hmanga structure hrang hrangte biomechanical integrity chu a chhe lo tur a ni tih a ni. Kan hypothesis pahnihna chu lateral TBW hian standard TBW nen hian result inang a nei dawn tih a ni.

Thiltih dan

Simple transverse patellar fracture chu pendulum saw hmangin truncated a ni a, chutah chuan technique thar 3 te chu a hnungzuiin khup hrang hrangah hman a ni a, chu chu mihring taksa peng hrang hranga siam dan him leh siam chhuah theih tur anga siam theih a nih theih nan (Figure 2 leh 3-a kan hmuh ang hian). Hlawhtling takin an hlawhtling vek a ni. Technique thar 3 te biomechanical integrity test nan hian biomechanical device hman a ni.

Rahchhuah

Test zawng zawng result chu Figure 4 leh 5-ah hian tarlan a ni.

Results atanga a lan dan chuan The configuration with the smallest total fracture gap displacement chu crossed kerf pins combined with lateral TBW (technique 3) a ni a, cycle 100 hnuah mean fracture gap displacement chu 0.43 mm (range 0.10-0.80 mm) a ni a, hei hi significant displacement 2 mm aiin a hniam hle.

Standard TBW crossed kerf pins (technique 1) nena inzawm chu a dawttu a ni a, mean fracture gap displacement chu 0.61 mm (0.06 to 2.06 mm) a ni.

Mean applied load chu 69.2 N. AO standard chu a chhe ber a, mean final fracture gap displacement chu 1.72 mm (0.47 to 2.24 mm) niin, mean applied load chu 79.6 N. AO standard chu a chhe ber a, mean final fracture gap displacement chu 1.72 mm (0.47 to 2.24 mm) a ni.

Cycle khata incremental displacement chungchangah chuan crossed kerf (technique 1 leh 3) structure pahnih hian displacement tenau zawk an nei a: cycle hnuhnung berah crossed kerf structure pahnih tan 0.27 mm a ni a, standard AO leh longitudinal kerf structure lateral TBW nei tan 0.41 mm leh 0.60 mm nen khaikhin chuan. hei hi crossed kerf structure hian load hnuaia fracture-ah stiffness nasa zawk a pe tih finfiahna a ni Hei hi crossed Clinch pin structure-in a pek fracture gap under load-ah stiffness nasa zawk a pe tih finfiahna a ni.

Sawiho

Results atanga a lan dan chuan Kirschner pin chu a chhehvel soft tissue atanga hla taka cross-shaped structure-a reorienting, mahse plane khata awm (chu chu patella hmalam convex surface hnung lama 5 mm) a awm reng chuan biomechanical integrity a tichhe lo va, internal fracture fixation stability a nghawng tha zawk a ni. Longitudinal kerf pin nena khaikhin chuan cruciform structure hian fracture block chu anterior tension lakah a stabilize tha zawk niin a lang a, articular surface-a compressive stress a tipung thei bawk.

Heng data te hian kan hypothesis hmasa ber, crossed kyphotic pins hi longitudinal kyphotic pins nena khaikhin chuan surgical procedure chhe zawk a ni lo tih a thlawp a, a nihna takah chuan structure pahnih hian crossed kyphotic pin hmanga longitudinal kyphotic pins aiin an thawk tha zawk a ni. Kan hypothesis pahnihna hi a inthlau hle a, hei hi he zirchianna atang hian lateral TBW result hi standard TBW nen tehkhin theih a nih leh nih loh hriat chian a la ni lo.

Hei hi TBW-a surgical approach ennawn leh mai maia AO technique aiin a chungnung zawkna lantir thei biomechanical study hmasa ber a ni. Additional cost a awm lo va, exposure tlem zawk a ngaih avangin procedure pawh a rang zawk thei bawk. Crossed kyphotic pin hman hian a chhehvel soft tissue (a bik takin quadriceps leh patellar tendons) te chhiatna a ti tlem a ni. Chu bakah, surgeon-te chuan covered soft tissues quality leh anterior metal internal fixation-a irritation emaw protrusion emaw hlauhawmna an ngaihtuah a nih chuan, he zirchianna hian TBW chu patella sir lehlamah dah chuan hei hi a pumpelh a, overall fixation a ti ha tih a tichiang tur a ni.

He zirchianna hian crossed kerf pin technique thar pahnih chu tuna AO-in simple transverse patella fracture enkawlnaah gold standard a sawi aiin a tha zawk tih a tilang a ni.