To investigate the evaluation of open reduction and internal fixation by tension band wiring for patellar fracture and early postoperative functional exercise.

Data were retrospectively collected from the patients who were admitted to the department of orthopaedics in the Affiliated Shunde Hospital of Jinan University from January 2017 to December 2019. The patients were grouped by median age (51 years). All the patients underwent open reduction and internal fixation by tension band wiring to treat patellar fracture under combined spinal-epidural anesthesia within three hours to 148 h after admission and early postoperative functional exercise. The relationships between the changes in the parameters such as waiting time before surgery, preoperative associated injury, white blood cell count (WBC), D-dimer (DD) level, postoperative X-rays, body temperature, and early postoperative functional exercise were compared and analyzed by Wilcoxon rank-sum test, Spearman’s correlation analysis, binary logistic regression analysis, and repeated measures analysis of variance.

The patients age >51 years showed longer waiting time before surgery than the patients age ≤51 years(Z=2.928, P<0.05). Age was shown to be negatively correlated with preoperative WBC, body temperature at 18: 00 on postoperative days one, two and three (r=-0.380, -0.300, -0.275, -0.310, all P<0.05). Positive correlations were observed between age and preoperative DD level, preoperative WBC and presence of associated injury, body temperature at 14: 00 on postoperative days one and two(r=0.377, 0.244, 0.288, 0.337, all P<0.05). Presence of associated injury[odds ratio(OR)=6.531, 95%confidence interval(CI)(1.672, 25.506), P=0.007] and high body temperature at 18: 00 on postoperative day one [OR=22.752, 95%CI (1.207, 428.853), P=0.037] were risk factors for the prolonged hospital stay, while preoperative DD level[OR=0.238, 95%CI (0.072, 0.785), P=0.018] was a protective factor the length of hospital stay. The body temperature of the patients age ≤ 51 years was higher than that in the patients age >51 years (F=6.321, P<0.05).

The available objective data should be sufficiently utilized as evaluation indicators for early postoperative functional exercise after open reduction and internal fixation by tension band wiring for patellar fracture.