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《The Journal of Traditional Chinese Orthopedics and Traumatology》 2017-01
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K- wire loosening after internal fixation with tension band made of K-wire and steel-wire for treatment of patella fractures:cause analysis and coping strategies

CHEN Xingyu;LIU Xiandong;CAO Wanjun;DU Liang;TANG Chengjie;ZHENG Jinwen;Sichuan Orthopaedic Hospital;The People's Hospital of Guang'an district in Guang'an City;  
Objective: To study the possible causes and coping strategies of K- wire loosening after internal fixation with tension band made of K- wire and steel- wire for treatment of patella fractures. Methods: The X- ray films of 17 patients with patella fractures who developed K- wire loosening after internal fixation with tension band made of K- wire and steel- wire from January 2014 to December 2015 were collected. The needle withdrawal distance,bending- degree of needle tail,distance from needle tip to patellar distal extreme and included angle between K- wire and axis of quadriceps femoris were measured by using infiniti system software,and the relationships between needle withdrawal distance and other 3 parameters were analyzed by using Pearson correlation analysis. Results: The needle withdrawal distance( 10. 02 + /- 5. 56 mm) was negatively correlated( r =- 0. 774,P = 0. 013; r =- 0. 710,P = 0. 007) with the bending- degree of needle tail( 117. 30 + /- 3. 52 degrees) and the included angle between K- wire and axis of quadriceps femoris( 17. 35 + /- 1. 75 degrees),and was positively correlated( r = 0. 550,P = 0. 037) with the distance from needle tip to patellar distal extreme( 11. 17 + /- 0. 81 mm).Conclusion: The possible causes of K- wire loosening after internal fixation with tension band made of K- wire and steel- wire for treatment of patella fractures include small bending- degree of needle tail,small included angle between K- wire and axis of quadriceps femoris and long distance from needle tip to patellar distal extreme,so the bending- degree of needle tail and the included angle between K- wire and axis of quadriceps femoris should be properly increased and the distance from needle tip to patellar distal extreme should be properly controlled in the surgery so as to reduce the possibility of K- wire loosening.
【CateGory Index】: R274.1
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