Open reduction and internal fixation of comminuted patellar fractures with headless compression screws and wiring technique

Suh, Kuen Tak; Suh, Jung Dong; Cho, Hyung Joon

doi:10.1016/j.jos.2017.10.002

Cited by 19 publications

(15 citation statements)

References 26 publications

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“…There are many problems in the treatment of circumferential cerclage wire fixation: due to the lack of fixed reliability, there are some problems in rehabilitation exercise, such as loosening and breaking of steel wire leading to the re-displacement of bone, failure of internal fixation and additional injury of the articular surface [2]. Cerclage wiring fixation is used as an adjunct with other fixation measures [16, 18]. However, Matsuo et al [20] fixed five cases of patellar fracture with soft tissue around the bone at the same time.…”

Section: Discussionmentioning

confidence: 99%

“…Early complications, such as contraction and stiffness of knee joint, contribute to poor long-term recovery of joint function. Some scholars reported that two or more fixation methods were combined to treat patellar comminuted fracture, such as circumferential cerclage wire fixation combined with modified tension band [16], non-absorbable suture cerclage combined with nickel-titanium patellar concentrator [17] and headless compression and wiring technique [18].…”

Section: Introductionmentioning

confidence: 99%

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Management of comminuted patellar fracture fixation using modified cerclage wiring

Sun

Sheng

et al. 2019

J Orthop Surg Res

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Background Although there are several different kinds of fixation techniques for displaced comminuted patellar fracture, the treatment remains a challenge for orthopaedic surgeons. The purpose of this study is to evaluate the effectiveness and safety of a fixation technique for comminuted patellar fracture fixation using modified cerclage wiring. Methods From February 2016 to April 2018, 38 cases of simple unilateral closed comminuted patellar fracture were treated by modified cerclage wiring. Among these cases, 16 patients were males and 22 were females, aged 23–68 years (average 40.4 ± 9.1 years). Comminuted patellar fractures were classified according to the AO/OTA classification: 10 cases were type 34-C2 (three fragments), 28 cases were type 34-C3 (more than three fragments). Postoperative complications including loosening of internal fixation, fragment re-displacement, nonunion, infection, breakage of internal fixation and traumatic osteoarthritis were assessed. The clinical results after operation were evaluated by the clinical grading scales of Böstman including range of movement, pain, work, atrophy, assistance in walking, effusion, giving way, and stair-climbing during follow-up. Results A total of 38 patients were followed up for 6–36 months (mean time 16.1 ± 5.8 months). The bone union radiographically occurred at approximately 2.5–3.5 months (mean time 2.92 ± 0.25 months). No postoperative complications, such as infection, dislocation, breakage of the implants, painful hardware, and post-traumatic osteoarthritis, were observed. According to the clinical grading scales of Böstman, satisfactory results were obtained, and the mean score at the final follow-up was 28.7 (range 20–30) points. Thirty-two patients (84.2%) with excellent results had a mean score of 29.5 ± 0.7 (range 28–30) points, and six patients (15.8%) with good results had a mean score of 24.5 ± 2.2 (range 20–27) points. The patients with excellent and good scores had active flexion of 130° (110–140). Conclusions Modified cerclage wiring can effectively treat comminuted patellar fracture and offers a new strategy resulting in satisfactory results without obvious complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of comminuted patellar fracture fixation using modified cerclage wiring

Sun

Sheng

et al. 2019

J Orthop Surg Res

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“…The South Korean author [3] suggested to x the Loose articular fragment with headless compression screw, but we found that the articular fragments usually were thin, we xed them with Kirschner wire under direct vision. In the follow-up, although no fragments were found to fall off, 2 of the 8 patients still suffered from unevenness of articular surface.…”

Section: Discussionmentioning

confidence: 94%

The additional iron cable fixation between proximal patella and tibial tuberosity to treat AO/OTA 34C3 patellar fracture

Zhang

Shen

2020

Preprint

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Background:It is very difficult to deal with AO/OTA 34C3 patellar fracture. Although the modified Kirschner wire tension band, the cerclage and plate has been proposed to treat it, the result is not very good. We found that if the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been carried out, the additional iron cable fixation between proximal patella and tibial tuberosity could resolve it effectively.Methods:Retrospective analysis was completed. 21 patients with AO/OTA 34C3 patellar fracture were treated in our department from January 2014 to January 2018. They were divided into 2 groups according to the operation plan. Group 1 (normal group), with 12 patients, was treated with modified Kirschner wire tension band with or without cerclage cable. Group 2 (cable group), with 9 patients, was treated with the additional iron cable fixation between proximal patella and tibial tuberosity when the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been completed.Results:The two groups of the age, sex ratio, trauma mechanism, operation time, free articular fragment, comorbidity and follow-up time had no significant statistical difference (P>0.05). There was no significant statistical difference between the two groups of the clinical results. (such as Bostman total score and its specific individual score, the excellent and good ratio, the complications, and the bone union time, etc.) (P>0.05).Conclusions:To deal with AO/OTA 34C3 patellar fracture, when the fixation of modified Kirschner wire tension band with or without the cerclage cable is not firm enough, the additional iron cable fixation between proximal patella and tibial tuberosity can resolve it effectively.

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“…Of the 21 patients with AO/OTA 34C3 patellar fracture that we implemented, there were 8 patients with free articular fragment. The South Korean author [10] suggested to fix the Loose articular fragment with headless compression screw, but we found that the articular fragments usually were thin, we fixed them with Kirschner wire under direct vision. In the follow-up, although no fragments were found to fall off, 2 of the 8 patients still suffered from unevenness of articular surface.…”

Section: Discussionmentioning

confidence: 97%

The additional iron cable fixation between proximal patella and tibial tuberosity to treat AO/OTA 34C3 patellar fracture

Zhang

Shen

2020

Preprint

View full text Add to dashboard Cite

Background: It is very difficult to deal with AO/OTA 34C3 patellar fracture. Although the modified Kirschner wire tension band, the cerclage and plate has been proposed to treat it, the result is not very good. We found that if the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been carried out, the additional iron cable fixation between proximal patella and tibial tuberosity could resolve it effectively.Methods: Retrospective analysis was completed. 21 patients with AO/OTA 34C3 patellar fracture were treated in our department from January 2014 to January 2018. They were divided into 2 groups according to the operation plan. Group 1 (normal group), with 12 patients, was treated with modified Kirschner wire tension band with or without cerclage cable. Group 2 (cable group), with 9 patients, was treated with the additional iron cable fixation between proximal patella and tibial tuberosity when the fixation was not firm enough after the modified Kirschner wire tension band with or without the cerclage had been completed.Results: The two groups of the age, sex ratio, trauma mechanism, operation time, free articular fragment, comorbidity and follow-up time had no significant statistical difference (P>0.05). There was no significant statistical difference between the two groups of the clinical results. (such as Bostman total score and its specific individual score, the excellent and good ratio, the complications, and the bone union time, etc.) (P>0.05).Conclusions: To deal with AO/OTA 34C3 patellar fracture, when the fixation of modified Kirschner wire tension band with or without the cerclage cable is not firm enough, the additional iron cable fixation between proximal patella and tibial tuberosity can resolve it effectively.

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Open reduction and internal fixation of comminuted patellar fractures with headless compression screws and wiring technique

Cited by 19 publications

References 26 publications

Management of comminuted patellar fracture fixation using modified cerclage wiring

Management of comminuted patellar fracture fixation using modified cerclage wiring

The additional iron cable fixation between proximal patella and tibial tuberosity to treat AO/OTA 34C3 patellar fracture

The additional iron cable fixation between proximal patella and tibial tuberosity to treat AO/OTA 34C3 patellar fracture

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