(i) Comminuted patellar fractures

Mehling, Isabella; Mehling, A.P.; Rommens, Pol Maria

doi:10.1016/j.cuor.2006.11.004

Cited by 17 publications

(18 citation statements)

References 11 publications

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“…Other reports have shown that cannulated screws with a low profile caused less soft-tissue irritation than K-wires. 4,5 This study showed that the CSTB group had higher scores than the MKTB group for ROM, pain, atrophy of the quadriceps femoris, and joint effusion, which arose from the method of performing the CSTB technique. The rates of removing implant have been reported to range from 37 to 55% for transverse patellar fractures, mainly because fixation with K-wires is associated with irritating pain of the soft tissue caused by the K-wires.…”

Section: Discussionmentioning

confidence: 89%

Management of patella fractures with different modalities

et al. 2019

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Background: Patella fracture is quite a common injury for all ages of patients, constituting approximately 1% of all skeletal injuries. Patella is the largest sesamoid bone in the body. The aim of study was to assess the functional outcome of patella fractures treated with modified tension band wiring using K wires and cannulated cancellous screws with tension band construct.Methods: This study was a prospective clinical study to be conducted at the Department of Orthopaedic Surgery, Chalameda Anand Rao Institute of Medical Sciences, Karimnagar from October 2016 to November 2018. Total, 20 patients with transverse patellar fractures were studied and divided into 2 groups according to the surgical technique: 10 patients were in the MKTB group and 10 patients in the CSTB group.Results: Total 20 patella fractures were included in this study. The Bostman’s score of ROM, pain, atrophy of quadriceps femoris, and effusion were all higher in the CSTB group than in the MKTB group.Conclusions: We conclude that compared with the MKTB technique, CSTB fixation is an effective surgical procedure for treatment of displaced transverse patellar fractures.

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Section: Discussionmentioning

confidence: 89%

Management of patella fractures with different modalities

et al. 2019

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“…Partial or total patellectomy is generally indicated when the patella is so severely comminuted that an accurate reduction and reconstruction of the retropatellar joint surface cannot be achieved. 9 The conservative treatment can be opted if the extensor mechanism is functioning as some non-displaced fractures, fractures in which the articular gaps are lesser than 2 mm and fractures in which deviated fragments are lesser than 3 mm. When these conditions cannot be satisfied, the surgical treatment should be recommended.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of 50 cases of patella fractures treated with different modalities

et al. 2018

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Background: Fractures of patella account for 1% of all skeletal injuries. There is no universal accepted treatment for patellar fractures. After a fracture of the patella, the best results are obtained by accurate reduction and stable internal fixation. Partial or total patellectomy is generally indicated when the patella is so severely comminuted that an accurate reduction and reconstruction of the retropatellar joint surface cannot be achieved.Methods: The prospective study of 50 cases of patellar fractures was carried out at the department of orthopaedics for the period from May 2015 to December 2017. The maximum period of follow up was 18 months with a minimum period of follow up of 5 months (average 11.68 months). Operative treatment was done in patella fractures for more than 2 mm of articular displacement or 3 mm of fragment separation. Surgical options includes internal fixation with tension band wiring with k wire and partial patellectomy with extensor mechanism repair.Results: We have studied 50 patients where 7 cases were treated conservatively. In the present series 22 patients were treated with internal fixation out of which 13 patients had excellent results. 6 patients had good results. 21 patients were treated with partial patellectomy where 6 patients had excellent results, 11 patients had good and 4 patients had fair results.Conclusions: Patella should be preserved and Osteosynthesis whenever possible has better chance for excellent results. A good surgical technique, optimal operation room environment and judicious use of antibiotics will reduce the possibility of infection.

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“…Patella injuries constitute up to 2 % of all fractures, with 70–90 % of these having a transverse fracture pattern [ 1 – 4 ]. Conventionally, open reduction and internal fixation is indicated for transverse patellar fractures with displacement of greater than 3 mm, articular incongruity of 2 mm or more, or a disrupted extensor mechanism [ 2 , 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Conventionally, open reduction and internal fixation is indicated for transverse patellar fractures with displacement of greater than 3 mm, articular incongruity of 2 mm or more, or a disrupted extensor mechanism [ 2 , 5 – 7 ]. The tension band wiring technique is the most common method of transverse patella fracture fixation [ 1 , 2 , 5 , 8 – 10 ]. This technique, although used widely, has certain distinct disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the outcomes of cannulated screws vs. modified tension band wiring fixation techniques in the management of mildly displaced patellar fractures

Lin

Liu

Xiao

et al. 2015

BMC Musculoskelet Disord

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BackgroundK wire fixation with tension band wiring has conventionally been used for the open reduction and internal fixation of the patella. However, it suffers from distinct disadvantages such as implant irritation, need for open reduction, incidence of palpable implants, and need for subsequent implant removal. A smaller incision with percutaneous fixation may be an alternative to this established conventional technique. Thus, the purpose of this trial was to compare the treatment outcomes of patients with mildly displaced patellar fractures treated with closed reduction and percutaneous cannulated screw fixation (CRCF) as compared to open reduction and tension band wiring fixation (ORTF). Specifically, we aimed to determine whether cannulated screw fixation was associated with improved clinical outcomes at 12 months as measured using the Lysholm score, pain scores, degree of flexion, range of motion, time to radiographic union, radiographic outcomes, and complication rates.MethodsSixty-three patients with transverse patellar fractures displaced less than 8 mm were included in this prospective, randomized, controlled trial, with 52 patients in the final data analysis. Thirty-two patients were operatively treated by CRCF with either two or three cannulated screws. Thirty-one patients were operatively treated by conventional ORTF using the modified tension band technique. At postoperative intervals of 3, 6, and 12 months, knee function was evaluated using the Lysholm score, pain was assessed using the visual analog scale (VAS) score, and active knee extensions and flexion were measured in degrees by goniometry.ResultsThe CRCF group had average Lysholm scores of 84.4 ± 5.8, 86.7 ± 6.4, and 93.2 ± 5.3 after 3, 6, and 12 months, respectively, which were significantly greater than those of the ORTF group (79.0 ± 5.3, p = 0.001; 81.5 ± 4.6, p = 0.002; and 89.8 ± 6.2, p = 0.039, respectively). Lower pain and squatting scores were the main reasons for the poorer Lysholm scores in the ORTF group. The VAS scores showed that the CRCF group had lower pain scores and better flexion and total range of motion (ROM) compared with the ORTF group after 3 and 6 months, although both groups had similar outcomes after 12 months. The mean fracture healing time of 2.65 months was similar in the CRCF groups (2.77 months; p = 0.440). Complication rates were 3/26 (11.5 %) in the CRCF group and 14/26 (53.4 %) in the ORTF group. Two patients in the CRCF group and eight patients in the ORTF group experienced skin irritation. In addition, two (7.7 %) patients in the CRCF group and 11 (42.3 %) patients in the ORTF group required implant removal because of symptoms due to the presence of the implants.ConclusionSurgical treatment of mild displaced (less than 8 mm) transverse patellar fractures by the CRCF technique provides satisfactory clinical results and excellent knee function, with little pain and a low incidence of complications at early follow-up (up to 6 months). These results suggest that the CRCF technique may be a superior alternativ...

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(i) Comminuted patellar fractures

Cited by 17 publications

References 11 publications

Management of patella fractures with different modalities

Management of patella fractures with different modalities

A prospective study of 50 cases of patella fractures treated with different modalities

Comparison of the outcomes of cannulated screws vs. modified tension band wiring fixation techniques in the management of mildly displaced patellar fractures

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