Separate vertical wiring for the fixation of comminuted fractures of the inferior pole of the patella.
J Bone Joint Surg Br
; 85(8): 1155-60, 2003 Nov.
Article
in En
| MEDLINE
| ID: mdl-14653599
ABSTRACT
Comminuted and displaced fractures of the inferiorole of the patella are not easy to reduce and it is difficult to fix the fragments soundly enough to allow early movement of the knee. We have evaluated the clinical effectiveness of the separate vertical wiring technique in acute comminuted fractures of the inferior pole of the patella. A biomechanical study was also performed using ten pairs of embalmed cadaver knees. A four-part fracture was made on the inferior pole of the patella and fixed by two separate vertical wires on one side and two pull-out sutures after partial patellectomy on the other. The ultimate load to failure in the first group was significantly higher than in the second (250.1+/- 109.7 N v 69.7 +/- 18.9 N, p < 0.002), as was the stiffness (279.9 +/- 76.4 N/mm v 23.2 +/- 11.4 N/mm, p < 0.001). The separate wire technique was used in 25 patients with comminuted fractures of the inferior pole of the patella who were followed up for a mean period of 22 months (10 to 50). All the fractures healed at a mean of seven weeks (6 to 10). No breakage of a wire or infection occurred. The mean grading at the final follow-up was 29.5 points (27 to 30) using the Böstman method. This technique preserved the length of the patella, fixed the comminuted fragments of the inferior pole and avoided long-term immobilisation of the knee.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patella
/
Bone Wires
/
Fractures, Comminuted
/
Fracture Fixation, Internal
/
Knee Injuries
Type of study:
Diagnostic_studies
/
Evaluation_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Bone Joint Surg Br
Year:
2003
Document type:
Article