Biomechanical Evaluation of Current Patella Fracture Fixation Techniques

Carpenter, James E.; Kasman, Roberta A.; Patel, Niraj; Lee, Michael L.; Goldstein, Steven A.

doi:10.1097/00005131-199707000-00009

Cited by 244 publications

(217 citation statements)

References 11 publications

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“…Currently, the usual surgical intervention for treatment of transverse patella fractures is open reduction with a sufficient incision and internal fixation using a K wire with the modified tension band method [5,6,18]. However, this approach is associated with delayed wound healing, postoperative adhesions, knee stiffness, and prolonged work disability [1,19].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Cable Pin System With Conventional Open Surgery for Transverse Patella Fractures

Mao

Liu

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The cable pin system is an effective device for fixation of transverse patella fractures. However, whether this device provides superior results using a minimally invasive technique instead of conventional open surgery using the K wire tension band method is unclear. Questions/purposes We asked whether a minimally invasive technique would be associated with (1) increased operative time; (2) reduced postoperative pain; (3) faster recovery of ROM; (4) higher knee scores; and (5) reduced complications. Methods Forty patients with displaced transverse fractures of the patella participated in this prospective, randomized, controlled trial. Twenty of these patients underwent a minimally invasive technique and the others had conventional open surgery using K wires. Some data for six of the 20 patients who underwent the minimally invasive technique were published in an earlier prospective, observational trial. At postoperative intervals of 1, 3, 6, 12, and 24 months, pain was measured by VAS scores, active flexion and extension of the knee were measured in degrees by goniometry, and knee function was evaluated using the Böstman clinical grading scale. Results Operative time was longer in the minimally invasive surgery group (54.3 ± 9.8 minutes versus 48.5 ± 6

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Section: Introductionmentioning

confidence: 99%

Comparison of the Cable Pin System With Conventional Open Surgery for Transverse Patella Fractures

Mao

Liu

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Traditionally patella fracture fixation was done with two longitudinal K wires and figure of eight Stainless steel wires [5] . Modification of this technique was done using cannulated and non cannulated screws [20] .…”

Section: Discussionmentioning

confidence: 99%

“…Improving stability of fixation can provide early mobilisation without fracture displacement. Modified tension band technique using longitudinal K wires and 18Guage stainless steel figure of eight wiring on anterior patella has been historically used and proved to give good stability [5,20] . Therefore we addressed the hardware and stability problems by using fibre wires and applying the biomechanical concept of tension band wiring and vertical wiring augmented with Krackow suturing of patellar tendon.…”

Section: Introductionmentioning

confidence: 99%

Vertical and figure of eight fibre wiring for patella fractures

George¹,

George²,

Chittaranjan³

et al. 2017

Int. J. Orthop. Sci.

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Background: Displaced patella fractures need to be treated by internal fixation for achieving good outcome. Metallic hardware related pain and irritation are one among the many reasons for reoperations. Fracture displacement can happen due to early mobilisation depending on bone quality and fracture pattern. The aim of our study was to evaluate the postoperative outcome and complication rates of patella fractures fixed with fibre wires in a vertical and figure of eight pattern. Methods: We retrospectively followed up all patella fractures fixed using fibre wires utilising Krackow stitches through patellar tendon, longitudinal fixation through fracture fragments and figure of eight wiring on anterior patella. We evaluated their clinical outcome, range of movement, time to union and complication rates. We also evaluated these for arthritic scenario and different fracture patterns. Results: We had 22 patients (mean age 50.7) with a mean follow up of 22.7 months, mean Bostman score of 23.5, mean range of movement 115 0 and mean time to union 13.5 weeks. Arthritic patients though united without any complications had an unsatisfactory score. None of the patients developed any hardware related complications, fracture displacement or needed an implant removal. Conclusion: Fibre wires can be used in vertical and figure of pattern for achieving fracture union with good clinical outcome without fracture displacement or symptomatic hardware problems.

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“…Various techniques of internal fixation have been recommended, including cerclage wiring, tension-band wiring with or without transfixing screws, external fixation, and percutaneous suture fixation [1,2,8,9]. There is universal agreement that early joint motion after the treatment of patellar fractures requires a stable internal fixation either by arthroscopy-assisted or open surgery [1,2,10].…”

Section: Discussionmentioning

confidence: 99%

“…There is universal agreement that early joint motion after the treatment of patellar fractures requires a stable internal fixation either by arthroscopy-assisted or open surgery [1,2,10].…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic inspection after the surgical treatment of patella fractures

Haklar

Kocaoğlu

Gereli

et al. 2008

International Orthopaedics (SICOT)

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After the treatment of patella fractures the only way to evaluate healing at the articular surface before implant removal is through arthroscopy. The purpose of this study was to examine the healing potential of the cartilage. Arthroscopy was performed in 18 patients at the time of implant removal. The mean age of the patients was 42.1 years. The time elapsed from the index surgery to the arthroscopy and implant removal surgery was 12.9 months. During the arthroscopy, we inspected articular step-off, cartilage loss, and joint surface irregularities. Cartilage irregularities were observed in 13 of the 18 patients. Five patients had well-healed cartilage at the patellar surface. Although none of the patients had displacement at final follow-up X-rays, step-off was detected in two patients during arthroscopy. Our observation showed that cartilage lesions did not correlate with clinical and radiological evaluation. Despite good knee scores, we observed surface irregularities, chondral lesions, and fibrillation in most of the cases implicating subsequent patellofemoral arthritis.

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Biomechanical Evaluation of Current Patella Fracture Fixation Techniques

Abstract: Combining interfragmentary screw fixation with the tension band principle appears to provide improved stability over the modified tension band or screws alone for transverse patella fractures. Cannulated screws allow for simple, reliable addition of a tension band to screw fixation.

Cited by 244 publications

References 11 publications

Comparison of the Cable Pin System With Conventional Open Surgery for Transverse Patella Fractures

Comparison of the Cable Pin System With Conventional Open Surgery for Transverse Patella Fractures

Vertical and figure of eight fibre wiring for patella fractures

Arthroscopic inspection after the surgical treatment of patella fractures

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