Outcome of low profile mesh plate in management of comminuted displaced fracture patella

Singer, Mohamed Salah; Halawa, Abdelsamie; Adawy, Adel

doi:10.1016/j.injury.2017.03.026

Cited by 35 publications

(43 citation statements)

References 19 publications

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“…Recent studies have described the use of plates for patella fractures with good results. [12][13][14][15]25 In our series, fracture patterns with an associated inferior pole fragment comprised the majority of the fractures. This fracture pattern merits special mention because these fractures also had a coronal split, disconnecting the anterior cortex from the articular surface.…”

Section: Discussionmentioning

confidence: 99%

“…Plate fixation of patella fractures allows for more rigid stabilization and earlier mobilization with potential for improved functional outcomes secondary to decreased stiffness and a decrease in symptomatic hardware, particularly in the case of comminuted fracture patterns. Case series of patellar plating have been published [12][13][14][15] and biomechanical studies have demonstrated equal or superior fixation strength with plates as compared with tension banding. 16,17 In this series, we examined patient-reported outcomes, range of motion (ROM), and complication rates in patients following plate fixation of patella fractures.…”

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confidence: 99%

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Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

et al. 2018

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Treatment of patella fractures is fraught with complications and historically poor functional outcomes. A fixation method that allows for early mobilization and decreases symptomatic hardware rates will improve knee range of motion, postoperative functional status, and reoperation rates. The purpose of this study was to evaluate the functional outcomes after locked plate osteosynthesis of patella fractures at a Level 1 trauma center. A retrospective case series was conducted of patients who underwent open reduction internal fixation (ORIF) of a patella fracture using a locked mesh plating technique coupled with neutralization of forces on the distal pole of the patella. Twelve patients were evaluated at a mean follow-up of 19 months (range, 6-30) with physical exam, functional outcomes, and radiographs. There were 9 women and 3 men with an average age of 66.1 years (range, 53-75). Radiographic bony union was achieved in all patients by 3-month follow-up. Visual Analog Pain Score averaged 1.7 (median, 1.0; range, 0-8), the mean Knee Outcome Score - Activities of Daily Living Scale was 83.9 (median, 92.1; range, 45.7-100.0), the mean Short Form Musculoskeletal Function Assessment (SMFA) Function Index was 9.9 (median, 3.7; range, 0.7-41.2), and the mean SMFA Bother Index was 11.1 (median, 3.1; range, 0-62.5). The SF-36 Physical Component Score mean was 48.4 ± 8.5 and the SF-36 Mental Component Score mean was 54.1 ± 9.6. No complications developed and there were no reoperations for nonunion, infection, or symptomatic hardware. This study demonstrates that locked plate osteosynthesis for operative patella fractures can reliably achieve bony union with potentially superior functional outcomes as compared with traditional methods. Further studies are needed to evaluate plate fixation for patella fractures, but early results are promising.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

et al. 2018

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“…[10] Despite several technical modifications, management of operative patella fractures continues to be a challenge with poor functional outcomes and high reoperation rates. [1,[11][12][13][14] There are several key advantages to using anterior tension wiring with K-wires for treating comminuted patella fractures include the following. For example, tensile forces can be transformed into compression forces, thereby making it possible for the bone to withstand high tension loads and promote fracture healing.…”

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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“…While plate fixation of patella fractures has not been described for periprosthetic patella fractures, recent case series of native patella fractures treated with plate fixation have been published [8][9][10][11] . Taylor et al in 2014 reported on 8 patients treated with anterior patellar plating, with union achieved in all patients and no reoperations for hardware complications [8] .…”

Section: Discussionmentioning

confidence: 99%

“…Lorich et al reported on 9 patients treated with patellar mesh plating with mean KOS-ADLS score of 84, no cases of non-union and only one reoperation for symptomatic hardware [9] . Singer et al in 2017 reported on 9 patients treated with mesh plating with no cases of non-union or reoperation [10] . The only published study comparing patellar plating to tension band fixation found plating was associated with statistically higher KOS-ADLS scores and significantly lower incidence of anterior knee pain [11] .…”

Section: Discussionmentioning

confidence: 99%