This meta-analysis compared the therapeutic effect of cable pin system（CPS） with K-wire tension band（KTB） in the treatment of patella fractures among Chinese Han population. The databases of PubM ed, Cochrane libr...This meta-analysis compared the therapeutic effect of cable pin system（CPS） with K-wire tension band（KTB） in the treatment of patella fractures among Chinese Han population. The databases of PubM ed, Cochrane library, China National Knowledge Infrastructure（CNKI）, Chinese Wan Fang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population. Literatures were screened according to the inclusion and exclusion criteria. The quality of the studies was assessed, and meta-analysis was performed using the Cochrane Collaboration＇s REVMAN 5.3 software. A total of 932 patients from 15 studies were included in this meta-analysis（426 fractures treated with CPS and 506 fractures treated with KTB）. There were significant differences in duration of hospital stay [mean difference（MD）=–1.07; 95% confidence interval（CI）： –1.71 to –0.43], fracture healing time（MD=–1.23; 95% CI： –1.68 to –0.77）, flexion degree of knee joint at 6 th month after operation（MD=14.82; 95% CI： 10.93 to 18.71）, incidence of postoperative complication [risk ratio（RR）=0.16; 95% CI： 0.09 to 0.27] and excellent-good rate of B？stman score（RR=1.09; 95% CI： 1.03 to 1.16） between the CPS group and KTB group, while no significant difference was found in operative time between the two groups（MD=–4.52; 95% CI： –11.70 to 2.67）. For the treatment of patella fractures among Chinese Han population, limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay, fracture healing time, flexion degree of knee at 6 th month after operation, incidence of postoperative complication and excellent-good rate of B？stman joint score. Due to the limitation of high quality evidence and sample size, more large-scale randomized controlled trials are needed to validate the findings in the future.展开更多
Amongst the many known techniques used for the management of fractures of the patella, the tension band wire fixation is a reliable treatment modality and has given consistently good results. In transverse patellar fr...Amongst the many known techniques used for the management of fractures of the patella, the tension band wire fixation is a reliable treatment modality and has given consistently good results. In transverse patellar fractures, a combination of cerclage wiring and tension band fixation gives a good mechanical stability and an environment conducive to healing. The fracture described herein is classified as 45-C1 (based on Orthopaedic Trauma Association classification) of the right knee of a forty three years old male patient. It was fixed with three vertical 1.5 mm K wires and double cerclage wire looped proximally through the quadriceps tendon and distally through the patellar ligament in a double figure-of-eight configuration. The average follow-up period was 7 months. The Activity of Daily Living Scale (ADLS) of the Knee Outcome Survey was used to assess symptoms and functional capability of the knee. The fracture union was achieved at an average of 10 weeks. Full range of knee motion was achieved by end of the third postoperative month. No complications, such as infection and implant failure were noted. The technique aims to stress the advantage of giving a balanced fixation addressing the bony elements (the fractured ends) as well as the soft tissue (the extensor apparatus).展开更多
The tensile deformation localization and the shear band fracture behaviors of sheet metals with strong anisotropy are numerically simulated by using Updating Lagrange finite element method, Quasi-how plastic constitut...The tensile deformation localization and the shear band fracture behaviors of sheet metals with strong anisotropy are numerically simulated by using Updating Lagrange finite element method, Quasi-how plastic constitutive theory([1]) and B-L planar anisotropy yield criterion([2]). Simulated results are compared with experimental ones. Very good consistence is obtained between numerical and experimental results. The relationship between the anisotropy coefficient R and the shear band angle theta is found.展开更多
To explore biomechanic characteristics and clinical outcome of absorbable polydloxanone (PDS) treating patellar fractures.Methods The tensile strength test of PDS 0-0 or PDS 1-0 sutures were made in WDW305 electro-uni...To explore biomechanic characteristics and clinical outcome of absorbable polydloxanone (PDS) treating patellar fractures.Methods The tensile strength test of PDS 0-0 or PDS 1-0 sutures were made in WDW305 electro-universal tester.A total of 60 cases were classified randomly and equally into two groups:treatment group (treated with the absorbable PDS tension hand) and Kirschner wire metals tension band control group (control group).Anatomy reduction was performed with towel clip fixation during operation.Treatment group was managed with diameter 1.5 mm Kirschner wires drilling two pores on the near or distal segment of patellar fracture end are penetrating through two strands of absorbable PDS 0-0 or PDS 1-0 sutures for a satisfactory fracture fixation.Control group was treated with Kirschner wires (2.0 mm in diameter) and steel wire (1.0 mm in diameter) of type “8” tension band fixation.Results Tensile strength testing showed that the biggest tensile of a strand PDS 0-0 sutures was 71.50 N and that of PDS 1-0 97.48 N,when the length was three times more than the initial.Two groups were followed up and the mean fracture healing time was two months,without broken wire or dislocation.Treatment group showed excellent clinical results in 21 cases,good in six and fair in three;while control group showed excellent clinical results in 19 cases,good in seven and fair in four,with no statistical difference compared with treatment group (χ2=0.32,P>0.05).Conclusion Absorbable PDS tension band has better characteristics of mechanics and creepage in treating patellar fractures.It can avoid defects of secondary operation and complications like needle-tail pain and sharped skin resulted from metal tension band fixation.Meanwhile,it is economic and worthy of further clinical application.16 refs,4 figs.展开更多
目的:观察四黄散联合间断垂直钢丝缝合加张力带对髌骨下极骨折患者膝关节活动度及骨折愈合时间的影响。方法:选取2021年9月至2022年9月丰城市中医院收治的髌骨下极骨折患者40例,按照随机数字表法分为对照组和试验组,每组20例。两组患者...目的:观察四黄散联合间断垂直钢丝缝合加张力带对髌骨下极骨折患者膝关节活动度及骨折愈合时间的影响。方法:选取2021年9月至2022年9月丰城市中医院收治的髌骨下极骨折患者40例,按照随机数字表法分为对照组和试验组,每组20例。两组患者均给予切开复位内固定,对照组给予间断垂直钢丝缝合联合张力带治疗,试验组给予四黄散联合间断垂直钢丝缝合加张力带治疗。观察两组患者术后6周、3个月、6个月、1年及末次随访时膝关节疼痛评分、屈伸活动范围(range of motion, ROM)、Bostman评分、骨折愈合时间、各项临床指标及并发症发生情况。结果:试验组术后6周、3个月、6个月、1年膝关节疼痛评分均低于对照组,差异有统计学意义(P<0.05)。试验组术后6周、3个月、6个月、1年ROM、Bostman评分高于对照组,差异有统计学意义(P<0.05)。试验组术后1年骨折愈合时间、各项临床指标均优于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:四黄散联合间断垂直钢丝缝合加张力带能改善髌骨下极骨折患者膝关节功能,降低术后并发症发生率,促进骨折早日愈合。展开更多
Considering strain localization in the form of a narrow band initiated just at peak stress, three analytical expressions for stressstrain curves of quasibrittle geomaterial (such as rock and concrete) in uniaxial tens...Considering strain localization in the form of a narrow band initiated just at peak stress, three analytical expressions for stressstrain curves of quasibrittle geomaterial (such as rock and concrete) in uniaxial tension, direct shear and uniaxial compression were presented, respectively. The three derived stressstrain curves were generalized as a unified formula. Beyond the onset of strain localization, a linear strain-softening constitutive relation for localized band was assigned. The size of the band was controlled by internal or characteristic length according to gradient-dependent plasticity. Elastic strain within the entire specimen was assumed to be uniform and decreased with the increase of plastic strain in localized band. Total strain of the specimen was decomposed into elastic and plastic parts. Plastic strain of the specimen was the average value of plastic strains in localized band over the entire specimen. For different heights, the predicted softening branches of the relative stressstrain curves in uniaxial compression are consistent with the previously experimental results for normal concrete specimens. The present expressions for the post-peak stressdeformation curves in uniaxial tension and direct shear agree with the previously numerical results based on gradient-dependent plasticity.展开更多
文摘This meta-analysis compared the therapeutic effect of cable pin system（CPS） with K-wire tension band（KTB） in the treatment of patella fractures among Chinese Han population. The databases of PubM ed, Cochrane library, China National Knowledge Infrastructure（CNKI）, Chinese Wan Fang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population. Literatures were screened according to the inclusion and exclusion criteria. The quality of the studies was assessed, and meta-analysis was performed using the Cochrane Collaboration＇s REVMAN 5.3 software. A total of 932 patients from 15 studies were included in this meta-analysis（426 fractures treated with CPS and 506 fractures treated with KTB）. There were significant differences in duration of hospital stay [mean difference（MD）=–1.07; 95% confidence interval（CI）： –1.71 to –0.43], fracture healing time（MD=–1.23; 95% CI： –1.68 to –0.77）, flexion degree of knee joint at 6 th month after operation（MD=14.82; 95% CI： 10.93 to 18.71）, incidence of postoperative complication [risk ratio（RR）=0.16; 95% CI： 0.09 to 0.27] and excellent-good rate of B？stman score（RR=1.09; 95% CI： 1.03 to 1.16） between the CPS group and KTB group, while no significant difference was found in operative time between the two groups（MD=–4.52; 95% CI： –11.70 to 2.67）. For the treatment of patella fractures among Chinese Han population, limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay, fracture healing time, flexion degree of knee at 6 th month after operation, incidence of postoperative complication and excellent-good rate of B？stman joint score. Due to the limitation of high quality evidence and sample size, more large-scale randomized controlled trials are needed to validate the findings in the future.
文摘Amongst the many known techniques used for the management of fractures of the patella, the tension band wire fixation is a reliable treatment modality and has given consistently good results. In transverse patellar fractures, a combination of cerclage wiring and tension band fixation gives a good mechanical stability and an environment conducive to healing. The fracture described herein is classified as 45-C1 (based on Orthopaedic Trauma Association classification) of the right knee of a forty three years old male patient. It was fixed with three vertical 1.5 mm K wires and double cerclage wire looped proximally through the quadriceps tendon and distally through the patellar ligament in a double figure-of-eight configuration. The average follow-up period was 7 months. The Activity of Daily Living Scale (ADLS) of the Knee Outcome Survey was used to assess symptoms and functional capability of the knee. The fracture union was achieved at an average of 10 weeks. Full range of knee motion was achieved by end of the third postoperative month. No complications, such as infection and implant failure were noted. The technique aims to stress the advantage of giving a balanced fixation addressing the bony elements (the fractured ends) as well as the soft tissue (the extensor apparatus).
基金The project supported by the National Natural Science Foundation of China and the Excellent Youth Teacher Foundation of the State Education Commission of China
文摘The tensile deformation localization and the shear band fracture behaviors of sheet metals with strong anisotropy are numerically simulated by using Updating Lagrange finite element method, Quasi-how plastic constitutive theory([1]) and B-L planar anisotropy yield criterion([2]). Simulated results are compared with experimental ones. Very good consistence is obtained between numerical and experimental results. The relationship between the anisotropy coefficient R and the shear band angle theta is found.
文摘To explore biomechanic characteristics and clinical outcome of absorbable polydloxanone (PDS) treating patellar fractures.Methods The tensile strength test of PDS 0-0 or PDS 1-0 sutures were made in WDW305 electro-universal tester.A total of 60 cases were classified randomly and equally into two groups:treatment group (treated with the absorbable PDS tension hand) and Kirschner wire metals tension band control group (control group).Anatomy reduction was performed with towel clip fixation during operation.Treatment group was managed with diameter 1.5 mm Kirschner wires drilling two pores on the near or distal segment of patellar fracture end are penetrating through two strands of absorbable PDS 0-0 or PDS 1-0 sutures for a satisfactory fracture fixation.Control group was treated with Kirschner wires (2.0 mm in diameter) and steel wire (1.0 mm in diameter) of type “8” tension band fixation.Results Tensile strength testing showed that the biggest tensile of a strand PDS 0-0 sutures was 71.50 N and that of PDS 1-0 97.48 N,when the length was three times more than the initial.Two groups were followed up and the mean fracture healing time was two months,without broken wire or dislocation.Treatment group showed excellent clinical results in 21 cases,good in six and fair in three;while control group showed excellent clinical results in 19 cases,good in seven and fair in four,with no statistical difference compared with treatment group (χ2=0.32,P>0.05).Conclusion Absorbable PDS tension band has better characteristics of mechanics and creepage in treating patellar fractures.It can avoid defects of secondary operation and complications like needle-tail pain and sharped skin resulted from metal tension band fixation.Meanwhile,it is economic and worthy of further clinical application.16 refs,4 figs.
文摘目的:观察四黄散联合间断垂直钢丝缝合加张力带对髌骨下极骨折患者膝关节活动度及骨折愈合时间的影响。方法:选取2021年9月至2022年9月丰城市中医院收治的髌骨下极骨折患者40例,按照随机数字表法分为对照组和试验组,每组20例。两组患者均给予切开复位内固定,对照组给予间断垂直钢丝缝合联合张力带治疗,试验组给予四黄散联合间断垂直钢丝缝合加张力带治疗。观察两组患者术后6周、3个月、6个月、1年及末次随访时膝关节疼痛评分、屈伸活动范围(range of motion, ROM)、Bostman评分、骨折愈合时间、各项临床指标及并发症发生情况。结果:试验组术后6周、3个月、6个月、1年膝关节疼痛评分均低于对照组,差异有统计学意义(P<0.05)。试验组术后6周、3个月、6个月、1年ROM、Bostman评分高于对照组,差异有统计学意义(P<0.05)。试验组术后1年骨折愈合时间、各项临床指标均优于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:四黄散联合间断垂直钢丝缝合加张力带能改善髌骨下极骨折患者膝关节功能,降低术后并发症发生率,促进骨折早日愈合。
文摘Considering strain localization in the form of a narrow band initiated just at peak stress, three analytical expressions for stressstrain curves of quasibrittle geomaterial (such as rock and concrete) in uniaxial tension, direct shear and uniaxial compression were presented, respectively. The three derived stressstrain curves were generalized as a unified formula. Beyond the onset of strain localization, a linear strain-softening constitutive relation for localized band was assigned. The size of the band was controlled by internal or characteristic length according to gradient-dependent plasticity. Elastic strain within the entire specimen was assumed to be uniform and decreased with the increase of plastic strain in localized band. Total strain of the specimen was decomposed into elastic and plastic parts. Plastic strain of the specimen was the average value of plastic strains in localized band over the entire specimen. For different heights, the predicted softening branches of the relative stressstrain curves in uniaxial compression are consistent with the previously experimental results for normal concrete specimens. The present expressions for the post-peak stressdeformation curves in uniaxial tension and direct shear agree with the previously numerical results based on gradient-dependent plasticity.
