Role of suture anchors in management of fractures of inferior pole of patella

Anand, Ashish; Kumar, Manish; Kodikal, Gautam

doi:10.4103/0019-5413.65149

Cited by 27 publications

(33 citation statements)

References 9 publications

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“…The functional outcome in different studies shows that fixation with K-wires and basket plate is definitely inferior to excision of patella. 14 These results were consistent with the results reported by study of Anand et al 4 The comminuted fracture of inferior pole of patella was investigated by Chang et al and reported that fixation usually fails and different metal implants does not offer any protection against failure. 13 Excision of the fragments of bone with attachment of the patellar tendon by transosseous pull-out suture is usually indicated when the fragments are severely comminuted.…”

Section: Discussionsupporting

confidence: 88%

“…3 The traditional method of treatment for displaced comminuted inferior pole fractures is excision of the comminuted pole followed by reattachment of the patellar tendon with trans osseous suture. 4,5 The reattachment of the ligament of patella to the proximal cancellous rough surface of fractured patella is controversial. Some trauma surgeons recommend attachment of the ligament of patella near the articular surfaces and others advocate reattachment near the anterior cortex.…”

Section: Introductionmentioning

confidence: 99%

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Outcome of Inferior Patellar Pole Avulsion Fractures

Joshi¹,

Dwivedi²,

Byanjankar³

et al. 2016

J Lumbini Med Coll

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Introduction: The optimal treatment for inferior pole patella avulsion fractures has still been a topic of debate. The options include (a) internal fixation of the pole fragment and (b) resection of the avulsed fragment and repair of the patellar ligament to the patella. We present the comparative outcomes for patients with displaced inferior pole patella treated by resection and transosseous Ethibond® Krackow suture repair of patellar ligament with open reduction and internal fixation with modified tension band wiring and circumferential wiring. Methods: During a three year period between August 2013 and September 2016, twenty consecutive patients with distal pole fractures of the patella were prospectively enrolled in this study. These patients were divided into two groups. Group-T patients were treated with open reduction and internal fixation with modified tension band wire and group-R patients by resection of the avulsed fragment and reattachment of the patellar ligament to the patella with #5 Ethibond®. Data entry and analysis was done by using SPSS version 20. Anatomical and functional outcome were compared. Results: Consecutive 20 patients were treated either with resection lower patellar pole (n=10) or with open reduction internal fixation with tension band wiring (n=10). Demographics were matched in two groups. Group-T required a longer hospital stay (U=13.5, p=0.005). Complications were seen more often in Goup-T compared to Group-R (p=0.005). Group-R had better scores (Bostman score U=6, p=0.001; SFMA U=7.5, p=0.001) and range of movement (p<0.05). Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had better outcome according to the Bostman and SFMA dysfunction score, shorter hospital stay, and less complications as compared to open reduction and internal fixation with tension band wire and circumferential wiring.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Outcome of Inferior Patellar Pole Avulsion Fractures

Joshi¹,

Dwivedi²,

Byanjankar³

et al. 2016

J Lumbini Med Coll

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“…Parsiyel patellektomi uygulanacaksa, kuadriseps ve patellar tendon kalın örgü dikişler veya çapa ile patellanın anteriyor korteksine tutturulur. [23] Dikişler düğümlenirken diz 90 derece fleksiyona alı-narak ameliyat sonrası fleksiyon kısıtlılığının önüne geçilmiş olur. Bu gibi durumlarda kemik tendon dizilimini sağlamak önemlidir aksi halde femoral kondiller üzerindeki temas kuvvetleri artar (Şekil 5).…”

Section: Tedavi̇unclassified

Patella fractures in adults

Şahin¹

2012

TOTBİD Dergisi

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Patella, ekstansör mekanizma içerisinde kuadriseps tendonu ile patellar tendon arasında bulunan bir sesamoid kemiktir. Dizin ekstansiyonunda kaldıraç gibi görev yapar ve kuadriseps kasının gücünü kuvvetlendirir. Patella kırıkları tüm iskelet sistemi kırık-larının yaklaşık %0.5-1.5'lik bir bölümünü oluşturur. Patella kırıkları doğrudan veya dolaylı travmalarla olabilir. Patella kırıklarının tedavisi kırığın tipine, kırık parçalarının büyüklüğüne ekstansör mekanizmanın bütünlüğüne ve eklem yüzünün düzgünlüğüne bağ-lıdır. Modifiye gergi bandı telleme tekniği, patella kırıklarında en sık kullanılan cerrahi tedavidir ve hemen hemen her tip kırıkta kullanılabilir. Tedavinin çeşidinden bağımsız olarak tüm patella kırıklarında erken iyileştirme önerilmektedir. Bu yazıda erişkinler-de görülen patella kırık çeşitleri tartışıldı ve güncel tedavi yöntemleri özetlendi.Anahtar sözcükler: Erişkin; patella kırığı; patellektomi; gergi bandı ile telleme.Hem patellanın fonksiyonu hakkındaki bilgisizlikten hem de cerrahi işlemlerdeki komplikasyonlar nedeniyle 1950 yılına kadar patellektomi patella kırık-larında standart tedavi olmuştur. Ancak 1950'lerin başlarında anteriyor tansiyon band tekniği bildirilmiş ve 1973'te bu yöntem AO grubu tarafından patella kırıkları için önerilmiştir. [1] Patella kırıkları tüm kırıkların %1'ini oluşturur ve 20-50 yaş arasında sıktır. Direkt veya indirekt kuvvetler sonucu oluşabilir. Yüksek enerjili travmalar sonrası görülen patella kırıklı hasta, aynı taraf femur kırığı açısından muhakkak araştırılmalıdır. Patella kırıklarının çoğu ister direkt ister indirekt kuvvetler sonucu oluşsun transverstir. Bununla beraber longitudinal veya yıldız şeklinde patella kırıkları da vardır ve genelde ayrışmamış kırıklardır. Superiyor ve inferiyor uçta avülsiyon kırıkları görülebilir hatta bu parçalar o kadar küçük olabilir ki esasen patella veya kuadriseps tendon rüptürü olarak düşünmek daha doğru olur. TANIPatella kırıkları, dizinin ön kısmına gelen direkt yüksek enerjili darbesi olan, düşme sonrası, dizini aktifThe patella is a sesamoid bone in the extensor mechanism between the quadriceps tendon and the patellar tendon. It functions as a lever for knee extension, augmenting the force of the quadriceps muscle. Fractures of the patella account for approximately 0.5% to 1.5% of all skeletal fractures. Fractures of the patella may result from either direct or indirect traumas. The treatment of patella fractures depends on the type of fracture, the size of the fragments, the integrity of the extensor mechanism and the congruity of the articular surface. Modified tension band wiring is the most commonly used surgical treatment for patella fractures and can be used for almost every type of fracture. Independent of the treatment modality, early rehabilitation is recommended for all type of patella fractures. In this article, types of patella fractures in adults were discussed and available treatment modalities were summarized.

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“…Because of this, treating this type of fracture poses a special problem [4,5] . Various treatment options include tension band wiring (TBW), circumferential wiring, cancellous screws fixation, fixation of the lower pole augmented by patellotibial SS wire loop, basket loop fixation and excision of the lower pole of the patella [6,7] . The superior fragment is important for effective extensor mechanism and to be preserved.…”

Section: Introductionmentioning

confidence: 99%

Functional evaluation of comminuted inferior pole patella treated by excision of comminuted fragment and trans-osseous fixation of patellar tendon using non- absorbable suture

Kubsad¹,

B²,

Pai³

et al. 2017

Int. J. Orthop. Sci.

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Inferior pole fracture accounts for only 20% of surgically treated patellar fractures. The treatment option for inferior pole patella fracture is still being debated. In our study we treated comminuted inferior pole patella fracture by excision of the comminuted fragment and transosseous fixation of patellar tendon by using Ethibond No. 5. Among 10 patients who were retrospectively studied, excellent and good results were found in 9 out of 10 patients according Gaur's criteria for knee evaluation. Hence we concluded that for comminuted inferior pole patella fractures, excision of the fragments and transosseous fixation of patellar tendon to the proximal patella is a very effective treatment method.

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Role of suture anchors in management of fractures of inferior pole of patella

Cited by 27 publications

References 9 publications

Outcome of Inferior Patellar Pole Avulsion Fractures

Outcome of Inferior Patellar Pole Avulsion Fractures

Patella fractures in adults

Functional evaluation of comminuted inferior pole patella treated by excision of comminuted fragment and trans-osseous fixation of patellar tendon using non- absorbable suture

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