Comparison of a minimally invasive osteosynthesis technique with conventional open surgery for transverse patellar fractures

Li-Wei Yao; Hai-Jiao Mao; Wen-Wei Dong; Ze-Ting Wu; Qing Liu

doi:10.1016/j.cjtee.2023.04.005

Comparison of a minimally invasive osteosynthesis technique with conventional open surgery for transverse patellar fractures

Chin J Traumatol. 2023 Sep;26(5):261-266. doi: 10.1016/j.cjtee.2023.04.005. Epub 2023 Apr 28.

Authors

Li-Wei Yao¹, Hai-Jiao Mao¹, Wen-Wei Dong¹, Ze-Ting Wu¹, Qing Liu²

Affiliations

¹ Department of Orthopaedic Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, 315020, Zhejiang province, China.
² Department of General Practice, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, 315020, Zhejiang province, China. Electronic address: fyliuqing@nbu.edu.cn.

Abstract

Purpose: The study aims to compare the efficacy and safety of a new minimally invasive osteosynthesis technique with those of conventional open surgery for transverse patellar fractures.

Methods: It was a retrospective study. Adult patients with closed transverse patellar fracture were included, and with open comminuted patellar fracture were excluded. These patients were divided into minimally invasive osteosynthesis technique (MIOT) group and open reduction and internal fixation (ORIF) group. Surgical time, frequency of intraoperative fluoroscopy, visual analogue scale score, flexion, extension, Lysholm knee score, infection, malreduction, implant migration and implant irritation in two groups were recorded and compared. Statistical analysis was performed by the SPSS software package (version 19). A p < 0.05 indicated statistical significance.

Results: A total of 55 patients with transverse patellar fractures enrolled in this study, the minimally invasive technique was performed in 27 cases, and open reduction was performed in 28 cases. The surgical time in the ORIF group was shorter than that in the MIOT group (p = 0.033). The visual analogue scale scores in the MIOT group were significantly lower than those in the ORIF group only in the first month after surgery (p = 0.015). Flexion was restored faster in the MIOT group than that in the ORIF group at one month (p = 0.001) and three months (p = 0.015). Extension was recovered faster in the MIOT group than that in the ORIF group at one month (p = 0.031) and three months (p = 0.023). The recorded Lysholm knee scores in the MIOT group were always greater than those in the ORIF group. Complications, such as infection, malreduction, implant migration, and implant irritation, occurred more frequently in the ORIF group.

Conclusion: Compared with the ORIF group, the MIOT group reduced postoperative pain and had less complications and better exercise rehabilitation. Although it requires a long operation time, MIOT may be a wise choice for transverse patellar fractures.

Keywords: Minimally invasive technique; Open reduction internal fixation; Patellar fractures.

MeSH terms

Adult
Fracture Fixation, Internal / methods
Fractures, Bone* / surgery
Humans
Minimally Invasive Surgical Procedures / methods
Open Fracture Reduction
Retrospective Studies
Treatment Outcome