![]() Good functional results and recovery can be expected. All 10 patients stated they were highly satisfied.Īnterior tension band wiring through cannulated screws for displaced inferior pole patella fractures is a safe, simple, and reliable alternative treatment with minimal soft tissue irritation. The modified tension band wiring technique using either Kirschner wires (k-wires) or screws perpendicular to the fracture with an anterior figure-of-eight metallic cerclage wire is probably the most commonly used 2. The average Bostman score was 28.7 out of 30 (range, 27-30), and average Short Musculoskeletal Functional Assessment dysfunction score was 24.1 out of 100 (range, 15-39). Various fixation methods or modifications of previous methods have been described for the internal fixation of patella fractures. Internal fixation refers to the fixation of screws and /or plates to enable or facilitate healing. ![]() Open reduction refers to open surgery to set bones, and is necessary for some fractures. No patient had loss of fracture reduction, implant migration, material failure, or soft tissue irritation. Open Reduction and Internal Fixation (ORIF) of the patella is a surgical procedure to treat a fractured patella (knee cap). Five patients have an average flexion lag of 17° (range, 10°-30°). The average range of knee motion arc was 122.5° (range, 95°-140°). With 1-year follow-up, all fractures healed clinically in an average of 8 weeks and radiographically on average by 12 weeks. There were three single-fragment fractures and seven comminuted fractures. The range of motion, loss of fracture reduction, implant migration, material failure, soft tissue irritation, and Bostman score and Short Musculoskeletal Functional Assessment dysfunction score were primary outcome measures. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.To present the treatment outcome for patients with displaced inferior pole patella fractures treated with anterior tension band wiring through cannulated screws.ĭuring a 2-year period between January 2007 and December 2008, 10 consecutive patients (mean age, 59.8 years) with distal pole fractures of the patella (Orthopaedic Trauma Association 45.A.1) were prospectively enrolled in this study.Īll 10 patients underwent vertical skin exposure, fracture open reduction, and internal fixation by anterior tension band wiring through 4.0-mm cannulated screws. The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). This is particularly important when the recommended agent is a new and/or infrequently employed drug. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. Usage and distribution for commercial purposes requires written permission. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). This case brings out the importance of keeping surgeons updated with the recent advancement in fracture management and also providing better alternatives for fracture fixation and patient care. As it was a revision surgery, the rehabilitation was delayed for the initial 2 weeks, though at the final follow-up patient had intact, united patella with full functioning. Reconstructing the same with TBW would have been a compromised fixation, thus taking the advantages of the angle stable locking patella plate, the patella was fixed again anatomically with better biomechanical stability. This cutout had led to the deficient anterior cortex of the lower segment of the patella with central bone loss. In the present case, the three-part, T-shaped patella fracture was initially fixed using the conventional method of TBW with good anatomical reduction and outcomes till the initial 6 weeks, following which the patient had accidental trauma to the same knee joint leading to cut out of the TBW with fracture displacement, which implies relatively inferior biomechanical strength of TBW as compared to the angular stable locking plate and the same has been proven in the several biomechanical studies.
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