本文收集近年来本院收治的髌骨骨折病人６９例，均采用改良张力带内固定手术。分析本组病人在张力带手术中的操作和手术本身的生物力学问题是发生术后克氏针旋转造成局部皮肤刺激影响膝关节功能恢复的主要因素，提出带孔克氏针这一改良设计方案供同道们参考。

Patella fracture is a common skeletal injury causing disfunction of the knee joint.Traditional nonoperative treatment with long leg splinting usually left a painful stiff knee or a nonunion fracture, Poor extension muscle power and limited range of motion are the common Sequence especialy in aged patients.Using modified anterior tension bend wiring,we have treated displaced and comminuted patella fracture in 69 patients since 1987.For preventing dislocation of Kirschner wire,we bend the hook in both the upper and lower end of the K-wire.Then rotate the hooks into the tendon of quadriceps and patella tendon,The main complication of this method was rotation of the K-wire during or after active training of the knee joint extension,When the hooks rotated towards to the subcutaneous area,it will cause painful flexion of the knee joint. We modified this procedure with pre-making a loop on the upper end of the K-wire,The tension bend wiring passed through the loop then tightened.More than two years follow-up showed no rotation of K-wire and no losening wiring was found with our new method.