武汉科技大学附属天佑医院关节骨科,湖北 武汉 430064
Received:22 August 2024,
Published:25 May 2025
移动端阅览
汪训进,刘拴.经骨隧道技术治疗髌骨下极骨折的研究进展[J].局解手术学杂志,2025,34(05):447-451.
WANG Xun-jin,LIU Shuan.Research progress of transosseous tunnel technique in the treatment of inferior pole fracture of the patella[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):447-451.
汪训进,刘拴.经骨隧道技术治疗髌骨下极骨折的研究进展[J].局解手术学杂志,2025,34(05):447-451. DOI: 10.11659/jjssx.08E024082.
WANG Xun-jin,LIU Shuan.Research progress of transosseous tunnel technique in the treatment of inferior pole fracture of the patella[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):447-451. DOI: 10.11659/jjssx.08E024082.
髌骨下极骨折因骨折块小且多,实现精准复位及牢靠固定是骨科手术的难点。随着众多外科医生的探索及验证,经骨隧道技术在髌骨下极骨折治疗中展现出重要的临床价值与应用前景。该技术通过构建骨性通道,提供固定支点,目前已衍生出多种术式,包括经骨隧道高张力线或钢丝固定、联合钛揽/钢丝张力带、聚髌器、带线锚钉、边缘钢板等。临床实践证实,这些手术方式均能有效维持骨折复位的稳定性,具有良好的临床效果。本文就经骨隧道技术治疗髌骨下极骨折的研究进展作一综述,为临床术式的选择提供参考。
Due to the small and numerous fracture fragments, achieving precise reduction and reliable fixation is a difficult point in orthopedic surgery for inferior pole fracture of the patella. With the exploration and verification of numerous surgeons, transosseous tunnel technique has shown important clinical value and application prospects in the treatment of inferior pole fracture of the patella. This technique provides fixed fulcrums by constructing transosseous tunnels, and has derived various surgery, including transosseous tunnel with high tension wire or steel wire fixation, combined titanium/tension band wiring, patellar concentrator,suture anchor, edge steel plate and so on. Clinical practice has proved that these surgeries can effectively maintain the stability of fracture reduction and have good clinical effects. This article reviews the research progress of transosseous tunnel technique in the treatment of inferior pole fracture of the patella, which provides a reference for the selection of clinical surgeries.
Fan M , Wang D , Sun K , et al . Study of double button plate fixation in treatment of inferior pole of patella fracture [J]. Injury , 2020 , 51 ( 3 ): 774 - 778 . doi: 10.1016/j.injury.2020.01.031 http://dx.doi.org/10.1016/j.injury.2020.01.031 .
Damrow DS , Van Valin SE . Patellar sleeve fracture with ossification of the patellar tendon [J]. Orthopedics , 2017 , 40 ( 2 ): e357 - e359 . doi: 10.3928/01477447-20161026-02 http://dx.doi.org/10.3928/01477447-20161026-02 .
李广磊 , 刘平 . 髌骨骨折手术治疗方式的研究进展 [J]. 中国修复重建外科杂志 , 2021 , 35 ( 8 ): 1057 - 1062 . doi: 10.7507/1002-1892. 202104068 http://dx.doi.org/10.7507/1002-1892.202104068 .
Pu S , Chen Y , Liang J , et al . Treatment of inferior pole fracture of the patella with tension-free external immobilization [J]. BMC Surg , 2022 , 22 ( 1 ): 337 . doi: 10.1186/s12893-022-01790-x http://dx.doi.org/10.1186/s12893-022-01790-x .
陈松 , 谢庆云 , 刘金标 , 等 . 髌骨下极骨折治疗的现状分析 [J]. 中国骨与关节杂志 , 2021 , 10 ( 12 ): 900 - 904 . doi: 10.3969/j.issn. 2095-252X.2021.12.005 http://dx.doi.org/10.3969/j.issn.2095-252X.2021.12.005 .
Huang W , Wu T , Wei Q , et al . Suture repair of patellar inferior pole fracture:transosseous tunnel suture compared with anchor suture [J]. Exp Ther Med , 2021 , 22 ( 3 ): 998 . doi: 10.3892/etm.2021.10430 http://dx.doi.org/10.3892/etm.2021.10430 .
Hu J , Guo X . An improvement on the technique of transosseous tunnels for the fixation of lower pole patella fracture:cerclage around the patella [J]. Medicine (Baltimore) , 2022 , 101 ( 9 ): e28979 . doi: 10.1097/md. 0000000000028979 http://dx.doi.org/10.1097/md.0000000000028979 .
Camarda L , Morello S , Balistreri F , et al . Non-metallic implant for patellar fracture fixation:a systematic review [J]. Injury , 2016 , 47 ( 8 ): 1613 - 1617 . doi: 10.1016/j.injury.2016.05.039 http://dx.doi.org/10.1016/j.injury.2016.05.039 .
Chang CH , Shih CA , Kuan FC , et al . Surgical treatment of inferior pole fractures of the patella:a systematic review [J]. J Exp Orthop , 2023 , 10 ( 1 ): 58 . doi: 10.1186/s40634-023-00622-y http://dx.doi.org/10.1186/s40634-023-00622-y .
高跃川 , 王歆峰 , 赵良春 , 等 . 改良锚钉置入角度和应用双滑轮技术治疗髌骨下极撕脱骨折 [J]. 中国骨伤 , 2022 , 35 ( 7 ): 683 - 687 . doi: 10.12200/j.issn.1003-0034.2022.07.017 http://dx.doi.org/10.12200/j.issn.1003-0034.2022.07.017 .
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 [J]. Int Orthop , 2016 , 40 ( 1 ): 149 - 154 . doi: 10.1007/s00264-015-2776-9 http://dx.doi.org/10.1007/s00264-015-2776-9 .
Hoshino CM , Tran W , Tinerij V , et al . Complications following tension-band fixation of patellar fractures with cannulated screws compared with Kirschner wires [J]. J Bone Joint Surg Am , 2013 , 95 ( 7 ): 653 - 659 . doi: 10.2106/JBJS.K.01549 http://dx.doi.org/10.2106/JBJS.K.01549 .
Seo JB , Lee DH , Kim KB , et al . Coracoid clavicular tunnel angle is related with loss of reduction in a single-tunnel coracoclavicular fixation using a dog bone button in acute acromioclavicular joint dislocation [J]. Knee Surg Sports Traumatol Arthrosc , 2019 , 27 ( 12 ): 3835 - 3843 . doi: 10.1007/s00167-019-05731-9 http://dx.doi.org/10.1007/s00167-019-05731-9 .
Zhou Y , Bai F , Liu X , et al . Shared ACL bone tunnel technique for repair of lateral meniscus posterior root tears combined with ACL reconstruction [J]. Orthop J Sports Med , 2022 , 10 ( 8 ): 232596712211 14319 . doi: 10.1177/23259671221114319 http://dx.doi.org/10.1177/23259671221114319 .
谢美明 , 廖冬发 , 龚凯 , 等 . 多向三维钢丝环套固定治疗髌骨下极撕脱骨折疗效分析 [J]. 中国修复重建外科杂志 , 2021 , 35 ( 2 ): 183 - 187 . doi: 10.7507/1002-1892.202008106 http://dx.doi.org/10.7507/1002-1892.202008106 .
叶俊材 , 聂静 , 陈智能 . 骨缝合加环扎治疗髌骨下极粉碎骨折 [J]. 浙江中西医结合杂志 , 2012 , 22 ( 5 ): 363 - 364 . doi: 10.3969/j.issn.1005-4561.2012.05.015 http://dx.doi.org/10.3969/j.issn.1005-4561.2012.05.015 .
Patel VR , Parks BG , Wang Y , et al . Fixation of patella fractures with braided polyester suture:a biomechanical study [J]. Injury , 2000 , 31 ( 1 ): 1 - 6 . doi: 10.1016/s0020-1383(99)00190-4 http://dx.doi.org/10.1016/s0020-1383(99)00190-4 .
Wright PB , Kosmopoulos V , Coté RE , et al . FiberWire is superior in strength to stainless steel wire for tension band fixation of transverse patellar fractures [J]. Injury , 2009 , 40 ( 11 ): 1200 - 1203 . doi: 10. 1016/j.injury.2009.04.011 http://dx.doi.org/10.1016/j.injury.2009.04.011 .
Achudan S , Kwek EBK . A novel technique for supplementing transosseous suture repair of inferior pole patella fractures with a tension band[J]. Indian J Orthop , 2020 , 54 (Suppl 2): 322 - 327 . doi: 10. 1007/s43465-020-00151-1 http://dx.doi.org/10.1007/s43465-020-00151-1 .
贾子刚 . 髌骨下极切除术75例临床分析 [J]. 浙江临床医学 , 2000 , 2 ( 3 ): 201 - 202 . doi: 10.3969/j.issn.1008-7664.2000. 03.044 http://dx.doi.org/10.3969/j.issn.1008-7664.2000.03.044 .
郭玉冬 , 王善正 , 陈翔溆 , 等 . 线缆固定技术治疗老年髌骨下极骨折 [J]. 中国矫形外科杂志 , 2017 , 25 ( 14 ): 1308 - 1312 . doi: 10.3977/j.issn.1005-8478.2017.14.13 http://dx.doi.org/10.3977/j.issn.1005-8478.2017.14.13 .
翟利锋 , 毕大卫 , 陈亿民 , 等 . 经骨隧道褥式缝合加钢丝张力带治疗髌骨下极骨折21例效果 [J]. 中国乡村医药 , 2014 , 21 ( 10 ): 26 - 27 . doi: 10.19542/j.cnki.1006-5180.2014.10.014 http://dx.doi.org/10.19542/j.cnki.1006-5180.2014.10.014 .
Kulkarni SL , Mannual S , Daragad M , et al . Management of patella fractures non-amenable to tension band wiring:series of nine cases with review of literature [J]. J Orthop Case Rep , 2022 , 12 ( 3 ): 38 - 42 . doi: 10.13107/jocr.2022.v12.i03.2708 http://dx.doi.org/10.13107/jocr.2022.v12.i03.2708 .
郑志辉 , 陈晟 , 李晓武 , 等 . 经骨隧道缝线固定技术与带线锚钉内固定治疗髌骨下极骨折的疗效比较 [J]. 中国骨与关节损伤杂志 , 2022 , 37 ( 8 ): 841 - 843 . doi: 10.7531/j.issn.1672-9935.2022. 08.016 http://dx.doi.org/10.7531/j.issn.1672-9935.2022.08.016 .
任科伟 , 姜雪峰 , 孙惠清 , 等 . 多道钢丝独立纵向垂直缝合固定有移位的髌骨下极骨折10例 [J]. 江苏医药 , 2016 , 42 ( 20 ): 2266 - 2268 . doi: 10.19460/j.cnki.0253-3685.2016.20.028 http://dx.doi.org/10.19460/j.cnki.0253-3685.2016.20.028 .
张羽 , 杨俊 . 改良垂直钢丝联合钢丝环扎内固定治疗髌骨下极骨折的效果及对骨代谢、疼痛因子的影响 [J]. 中国医学创新 , 2024 , 21 ( 16 ): 38 - 44 . doi: 10.3969/j.issn.1674-4985.2024. 16.008 http://dx.doi.org/10.3969/j.issn.1674-4985.2024.16.008 .
He S , Huang X , Yan B , et al . Modified technique of separate vertical wiring for the fixation of patellar inferior pole fracture [J]. J Orthop Trauma , 2018 , 32 ( 4 ): e145 - e150 . doi: 10.1097/bot.000000000000 1080 http://dx.doi.org/10.1097/bot.0000000000001080 .
夏招 . 独立垂直钢丝技术联合钢丝环扎强化技术治疗髌骨下极骨折 [J]. 临床骨科杂志 , 2024 , 27 ( 1 ): 46 . doi: 10.3969/j.issn. 1008-0827.2024.01.014 http://dx.doi.org/10.3969/j.issn.1008-0827.2024.01.014 .
Fan W , Liu J , Tan X , et al . Candy box technique for the fixation of inferior pole patellar fractures:finite element analysis and biomechanical experiments [J]. BMC Musculoskelet Disord , 2023 , 24 ( 1 ): 835 . doi: 10.1186/s12891-023-06946-1 http://dx.doi.org/10.1186/s12891-023-06946-1 .
龙显斌 , 贺常仁 . 爱惜邦线U形缝合联合聚髌器治疗髌骨下极骨折 [J]. 医学理论与实践 , 2017 , 30 ( 9 ): 1261 - 1263 . doi: 10.19381/ j.issn.1001-7585.2017.09.005 http://dx.doi.org/10.19381/j.issn.1001-7585.2017.09.005 .
Chen R , Cao H , Sun Z , et al . The clinical outcome of the reduction of the patellar inferior pole fracture with wire cerclage through a generated bone hole,in combination with patellar concentrator:a retrospective comparative study [J]. J Orthop Surg Res , 2022 , 17 ( 1 ): 117 . doi: 10.1186/s13018-022-03014-7 http://dx.doi.org/10.1186/s13018-022-03014-7 .
张欣 , 袁建敏 , 丁国正 , 等 . 带线锚钉联合髌骨纵向钻孔Nice结捆扎技术治疗髌骨下极骨折 [J]. 中国修复重建外科杂志 , 2023 , 37 ( 6 ): 675 - 680 . doi: 10.7507/1002-1892.202302040 http://dx.doi.org/10.7507/1002-1892.202302040 .
郑晓明 , 王康振 , 张会良 , 等 . 带线锚钉联合骨隧道缝合治疗髌骨下极骨折的临床疗效 [J]. 中国实用医药 , 2022 , 17 ( 3 ): 33 - 35 . doi: 10.14163/j.cnki.11-5547/r.2022.03.011 http://dx.doi.org/10.14163/j.cnki.11-5547/r.2022.03.011 .
陈俊波 , 朱广平 , 张鑫 . 纵向钢丝捆扎结合锚钉治疗髌骨下极骨折 [J]. 中国中医骨伤科杂志 , 2017 , 25 ( 4 ): 67 - 69 .
Barber FA , Herbert MA . All-suture anchors: biomechanical analysis of pullout strength, displacement, and failure mode [J]. Arthroscopy , 2017 , 33 ( 6 ): 1113 - 1121 . doi: 10.1016/j.arthro.2016.09.031 http://dx.doi.org/10.1016/j.arthro.2016.09.031 .
Cho WT , Sakong S , Sunwoo J , et al . Clinical outcome of rim-plate-augmented separate vertical wiring with supplementary fixation for the treatment of patellar fracture associated comminuted inferior pole [J]. Sci Rep , 2023 , 13 ( 1 ): 13430 . doi: 10.1038/s41598-023-40417-w http://dx.doi.org/10.1038/s41598-023-40417-w .
罗朝松 , 曾东 , 严超 , 等 . 垂直钢丝结合微型钢板治疗髌骨下极骨折 [J]. 骨科 , 2021 , 12 ( 2 ): 170 - 172 . doi: 10.3969/j.issn. 1674-8573.2021.02.014 http://dx.doi.org/10.3969/j.issn.1674-8573.2021.02.014 .
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
