Vertical Open Patella Fracture, Treatment, Rehabilitation and the Moment to Fixation

Abstract

Patella fracture is relatively uncommon and the vertical trace fracture represents almost 12-17%. The open patella fracture expresses 6-30%. The association of these two uncommon conditions was the aim of this case report even as the treatment and the moment of fixation (definitive surgical treatment). A 27-year-old man after a motorcycle accident showed an open patella fracture classified as a Gustilo and Anderson type IIIA lesion. The patient was immediately treated with precocious surgery fixation with a modified tension band which consists of two parallel K-wires positioned orthogonal to the fracture line and a cerclage wire shaped anteriorly at patella as an eight. The premature fixation benefited the infection prevention and provided earlier joint motion, which increased the nutrition of articular cartilage. Six months postoperatively, the patient had a satisfactory joint motion with full extension and 116° of joint flexion and returned to his daily life activities without restriction. Twelve months postoperatively, the patient had full extension and 120° of knee flexion without pain, joint effusion and instability. Muscle strength force was considered normal at grade V. In conclusion, early chirurgic treatment and precocious articular mobilization improve prognosis, suggesting that the employment of these practices should be adopted whenever possible in most of the open fractures.

Open lateral femoral condyle fracture concomitant with a vertical patella fracture in an adolescent: A case report

“…Comminuted patella fracture and associated fractures of the other joints can also be found. Open patella fractures have higher incidences of complications as compared with closed fractures, which mostly involves infection and non-union [7] . Immediate fixation as performed in this case is recommended in type I, II and IIIA [7] .…”

Comparison of the Kirschner Wire Tension Band with a Novel Nickel–Titanium Arched Shape–Memory Alloy Connector in Transverse Patellar Fractures: A Retrospective Study

“…Maximum flexion angle of the affected joint (degree) >2 mm, are usually treated surgically. 18 Various methods are available for treating this type of patellar fracture; the main surgical techniques include the K-wire tension band, lag screws, and the cable pin system. 19,20 The K-wire tension band is a traditional, classical surgical method for treating patellar fractures, 21 and this status means it has a relatively reliable biomechanical fixation effect and can effectively convert tension stress into compressive stress.…”

“…Comparison of mobility of the affected joint and the contralateral joint within 5 weeks postoperatively in the ASC group (FO2) >2 mm, are usually treated surgically 18. Various methods are available for treating this type of patellar fracture; the main surgical techniques include the K-wire tension band, lag screws, and the cable pin system.…”

Surgery of patellar fractures using a medial parapatellar approach

“…Typically, an image intensifier is used following reduction of the extra-articular portion of the patella using pointed reduction forceps or K-wires, after exposing the site of the patellar fracture via vertical or transverse dissection. 7,8 This method differs from the one that is used for other intra-articular fractures, wherein the reduction state is evaluated by directly observing the articular facet.…”