Tyler B Moore1, Bharat R Sampathi2, David P Zamorano3, Martin C Tynan4, John A Scolaro5. 1. Ashley Regional Medical Center, Vernal, Utah, USA. Electronic address: Tyemoe9@gmail.com. 2. University of California, Irvine, Orange, CA, USA. Electronic address: bsampath@uci.edu. 3. St. Alphonsus Medical Center, Boise, ID, USA. Electronic address: dpzamorano@hotmail.com. 4. University of California, Irvine, Orange, CA, USA. Electronic address: mctynan@uci.edu. 5. University of California, Irvine, Orange, CA, USA. Electronic address: jscolaro@uci.edu.
Abstract
INTRODUCTION: Comminuted patella fractures are uncommon and difficult fractures to manage. Multiple treatment modalities have been suggested, with little clinical data to support practice. Recent biomechanical and technical investigations have described successful plate fixation of comminuted patella fractures. The purpose of this study was to evaluate radiographic, clinical and functional outcome of comminuted patella fractures treated with a fixed angle locking plates. We believe stable fixation, which results in successful fracture union and functional recovery, can be achieved with this technique. MATERIALS AND METHODS: A retrospective review was performed at a single regional academic Level 1 trauma hospital. All comminuted patella fractures treated with a fixed angle locking plate (AO/OTA 34C2 and C3) over a six-year period were evaluated. Thirty-six patients were identified. Average length of follow up was 154 weeks (range 12-297 weeks). Twenty patients were available for functional outcome scoring. Primary outcome measures were: Knee Outcome Score (KOS), Lower Extremity Functional Scale (LES) and goniometer measured knee range of motion. Secondary outcomes evaluated the need for additional screw or cerclage fixation, reoperation for any reason, bothersome hardware, infection and nonunion. RESULTS: Average KOS = 57.2 (20-74), average LES = 58.9 (15-80). Median extension = 0° (full extension), median flexion = 130°. Supplemental screws were used in 17/36 cases; cerclage used in 2/36 cases. Hardware irritation was noted in 4/20 patients, no patient requested elective hardware removal, one patient had failure of fixation and no nonunions were identified. CONCLUSION: Fixed angle plate stabilization of comminuted patella fractures is a viable technique for fracture fixation. Good to excellent return of knee function and low complication rates, including need for hardware removal, can be expected.
INTRODUCTION: Comminuted patella fractures are uncommon and difficult fractures to manage. Multiple treatment modalities have been suggested, with little clinical data to support practice. Recent biomechanical and technical investigations have described successful plate fixation of comminuted patella fractures. The purpose of this study was to evaluate radiographic, clinical and functional outcome of comminuted patella fractures treated with a fixed angle locking plates. We believe stable fixation, which results in successful fracture union and functional recovery, can be achieved with this technique. MATERIALS AND METHODS: A retrospective review was performed at a single regional academic Level 1 trauma hospital. All comminuted patella fractures treated with a fixed angle locking plate (AO/OTA 34C2 and C3) over a six-year period were evaluated. Thirty-six patients were identified. Average length of follow up was 154 weeks (range 12-297 weeks). Twenty patients were available for functional outcome scoring. Primary outcome measures were: Knee Outcome Score (KOS), Lower Extremity Functional Scale (LES) and goniometer measured knee range of motion. Secondary outcomes evaluated the need for additional screw or cerclage fixation, reoperation for any reason, bothersome hardware, infection and nonunion. RESULTS: Average KOS = 57.2 (20-74), average LES = 58.9 (15-80). Median extension = 0° (full extension), median flexion = 130°. Supplemental screws were used in 17/36 cases; cerclage used in 2/36 cases. Hardware irritation was noted in 4/20 patients, no patient requested elective hardware removal, one patient had failure of fixation and no nonunions were identified. CONCLUSION: Fixed angle plate stabilization of comminuted patella fractures is a viable technique for fracture fixation. Good to excellent return of knee function and low complication rates, including need for hardware removal, can be expected.
Authors: Alexander Ellwein; Helmut Lill; Rony-Orijit DeyHazra; Tomas Smith; Jan Christoph Katthagen Journal: Int Orthop Date: 2019-04-30 Impact factor: 3.075
Authors: Kai Fehske; Markus T Berninger; Lena Alm; Reinhard Hoffmann; Johannes Zellner; Clemens Kösters; Stefan Barzen; Michael J Raschke; Kaywan Izadpanah; Elmar Herbst; Christoph Domnick; Jan Philipp Schüttrumpf; Matthias Krause Journal: Unfallchirurg Date: 2020-12-17 Impact factor: 1.000