Comparison between patella ligament wiring and inferior polar patellectomy for inferior polar fracture of the patella

Objective To compare the effect between patella ligament wiring and inferior polar patellectomy for inferior polar fracture of the patella.Methods 33 cases of inferior polar fracture of the patella(group A)were undergone excision of inferior polar of the patella and 27 cases(group B)by repairing patella ligament with wring were recruited.The anterior longitudinal incision of the knee was used for all patients.Group A were performed patellar ligament origin reconstruction.Group B were undergone drilling a transversal bone tunnel at tubercle of tibia and near fracture end of the patella,then fixing tubercle of tibia and near fracture end of the patella by using a diameter  1.25 mm steel-wire of 8 at 45° of genu flex and positioning patellar fracture.The front aponeurosis of patella and quadriceps femoris pavilion were repaired for fixing patellar fracture.Plaster splint was used for all patients postoperation about 3～6 weeks.Results 29 patients of group A were followed up for 12~21 months,the tendon and bone got healing;27 patients of group B were followed up for 12~24 months,and the fractures all healed.There is no statistical significance between heal rate and heal time(P0.05).HSS scale of the knee function and the maximum range of flexion were with statistical significance(P0.05).The maximum range of hyperextension was not statistical significant different(P0.05).Conclusions Inferior polar patellectomy increases patellofemoral joint pressure and leads to arthralgia and traumatic arthritis;The patella declines during flexion,and the extensor mechanism is destroyed.Reconstructing normal anatomy of the patella through patella ligament wring overcomes the above-mentioned shortages and surpasses the former for functional rehabilitation of the knee.