Die Plattenosteosynthese der Patellafraktur – Technik und erste Ergebnisse einer prospektiven Studie

Ellwein, Alexander; Lill, Helmut; Jensen, Gunnar; Grüner, A.; Katthagen, J. Christoph

doi:10.1007/s00113-016-0213-1

Cited by 16 publications

(17 citation statements)

References 28 publications

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“…[ 15 ] The primary disadvantage of this technique is implant-related complications. One study reported a postoperative complication rate of 18%, [ 16 ] which included the following: failure of fixation; rupture of a wire used for the tension band due to repetitive motion, resulting in disruption of the fractured site [ 17 ] ; and prolonged recovery and poor function of knee due to the biomechanical limitations of the tension band construct (e.g., early motion is limited to prevent loss of fracture reduction). [ 18 ]…”

Section: Discussionmentioning

confidence: 99%

A novel technique of using a miniature plate in combination with tension band wiring to treat comminuted patellar fractures

et al. 2018

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Traditionally, tension band fixation has been used for treating simple fracture patterns; however, fixation remains a challenge, especially for comminuted fractures. We describe a new method of operation using a combination of a miniature plate with tension band wiring to treat comminuted patellar fractures. The aim of this technique is to transform complicate fractures into simple transverse fractures. As far as we know, no studies using a similar method have been found.The purpose of this study was to assess the effectiveness of a novel technique in which a miniature plate is used in combination with tension band wiring to treat comminuted patellar fractures.Between March 2013 and May 2015, 16 patients with closed, displaced, comminuted fractures of the patella were included in the present study. All subjects underwent fixation using a combination of a miniature plate with a tension band wire. Knee function and patient status were evaluated at 12 months using the Böstman knee score and Lysholm knee scale.The average follow-up period was 15.6 months (range, 12–20 months). At the 12-month follow-up, bone healing was satisfactory in all patients. The average postoperative Lysholm score was 91.6 ± 1.4 (range, 84–97). The average postoperative Böstman scale score was 26.4 ± 0.5 (range, 22–30), thereby indicating excellent results in 4 patients and good results in 12. No patients required reoperation.The results demonstrate that this new technique is an effective and safe treatment option for comminuted patella fractures, as it is associated with good clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

A novel technique of using a miniature plate in combination with tension band wiring to treat comminuted patellar fractures

et al. 2018

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“…[15] The primary disadvantage of this technique is implant-related complications. One study reported a postoperative complication rate of 18%, [16] which included the following: failure of fixation; rupture of a wire used for the tension band due to repetitive motion, resulting in disruption of the fractured site [17] ; and prolonged recovery and poor function of knee due to the biomechanical limitations of the tension band construct (e.g., early motion is limited to prevent loss of fracture reduction). [18] Despite the high reoperation rate, modified anterior tension wiring is still used.…”

Section: Discussionmentioning

confidence: 99%

A novel technique of using a miniature plate in combination with tension band wiring to treat comminuted patellar fractures

2018

Medicine

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Traditionally, tension band fixation has been used for treating simple fracture patterns; however, fixation remains a challenge, especially for comminuted fractures. We describe a new method of operation using a combination of a miniature plate with tension band wiring to treat comminuted patellar fractures. The aim of this technique is to transform complicate fractures into simple transverse fractures. As far as we know, no studies using a similar method have been found.The purpose of this study was to assess the effectiveness of a novel technique in which a miniature plate is used in combination with tension band wiring to treat comminuted patellar fractures.Between March 2013 and May 2015, 16 patients with closed, displaced, comminuted fractures of the patella were included in the present study. All subjects underwent fixation using a combination of a miniature plate with a tension band wire. Knee function and patient status were evaluated at 12 months using the Böstman knee score and Lysholm knee scale.The average follow-up period was 15.6 months (range, 12-20 months). At the 12-month follow-up, bone healing was satisfactory in all patients. The average postoperative Lysholm score was 91.6 ± 1.4 (range, 84-97). The average postoperative Böstman scale score was 26.4 ± 0.5 (range, 22-30), thereby indicating excellent results in 4 patients and good results in 12. No patients required reoperation.The results demonstrate that this new technique is an effective and safe treatment option for comminuted patella fractures, as it is associated with good clinical outcomes.Abbreviation: K = Kirschner.

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“…Zudem hatte eine präoperative CT-Diagnostik in 49 % Einfluss auf die Therapiestrategie. Postoperativ ist die sichere Beurteilung der Fixation aller Fragmente, der Implantatlage sowie einer möglichen verbliebenen Gelenkstufe durch ein alleiniges Nativröntgen ebenfalls eingeschränkt [15]. Aus diesem Grund empfehlen die Autoren insbesondere bei Mehrfragmentfrakturen die großzügige Indikation zur prä-und postoperativen CT-Diagnostik.…”

Section: Diagnostikunclassified

“…Die verbesserte Primärstabilität ermöglicht eine sofortige Vollbelastung, welche die Rehabilitation und Rückkehr in den Alltag beschleunigt [15]. Sechs Monate postoperativ sind durchweg gute bis sehr gute klinische Ergebnisse beschrieben, bei 97 % des gesunden Bewegungsumfanges [15]. Zudem zeigt sich mit 12 % eine ebenfalls geringe Komplikationsrate.…”

Section: Winkelstabile Plattenosteosyntheseunclassified

Frakturversorgung der Patella

Ellwein¹,

Lill²

2019

OP-JOURNAL

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ZusammenfassungDie Therapie für Patellafrakturen wird in Abhängigkeit von Klinik und radiologischer Diagnostik gestellt. Frakturen mit einer Gelenkstufe kleiner als 2 mm und erhaltener Streckfähigkeit des Kniegelenkes können konservativ behandelt werden. Die Zuggurtungsosteosynthese stellt eine Standardversorgung dislozierter Querfrakturen dar. Limitationen sind in der unzureichenden Stabilisierung von Mehrfragmentfrakturen sowie der hohen Komplikationsrate zu sehen. Die Schraubenosteosynthese mit mindestens zwei Schrauben ist eine Alternative für Querfrakturen mit niedriger Komplikationsrate. Die Kombination aus kanülierten Schrauben mit additiver Zuggurtung durch die Schrauben vereint die Vorteile beider Verfahren. Trotz der höheren Stabilität bleibt die Versorgung von Mehrfragmentfrakturen eingeschränkt. Moderne winkelstabile Platten ermöglichen durch ihre multiplen Schraubenlöcher eine Versorgung von Mehrfragmentfrakturen. Aufgrund ihrer hohen Stabilität ist eine sofortige Vollbelastung möglich. Erste klinische Ergebnisse sind vielversprechend.

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Die Plattenosteosynthese der Patellafraktur – Technik und erste Ergebnisse einer prospektiven Studie

Abstract: Locked plating of patella fractures is a reliable alternative treatment with good functional outcomes and low complication rates.

Cited by 16 publications

References 28 publications

A novel technique of using a miniature plate in combination with tension band wiring to treat comminuted patellar fractures

A novel technique of using a miniature plate in combination with tension band wiring to treat comminuted patellar fractures

A novel technique of using a miniature plate in combination with tension band wiring to treat comminuted patellar fractures

Frakturversorgung der Patella

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