The management of nonunion and delayed union of patella fractures: a systematic review of the literature.
Int Orthop
; 35(6): 791-5, 2011 Jun.
Article
em En
| MEDLINE
| ID: mdl-20680273
ABSTRACT
Nonunion and delayed union of patella fractures are rare conditions that are fraught with challenges. There exists limited evidence in the literature to guide the clinician in the management of these complications. Therefore, the purpose of this study was to perform a systematic review of the available evidence on the management of nonunion and delayed union of patella fractures. A total of five publications which met our criteria were identified and formed the basis of this study. The decision making in the treatment of this condition is based on the functional demands of the patient, the factors that led to the development of the nonunion, the potential impact of the biomechanical effects of a total patellectomy, and the presence of an intact extensor mechanism of the knee for a later reconstructive procedure. Patients with low functional demands may be managed with nonoperative methods; however, those who perform heavy physical work or participate in sports usually require open reduction and internal fixation. Tension band wiring is the treatment of choice for patients suitable for a reconstructive procedure. Partial or total patellectomy is also an option for small distal fragments or an inability to satisfactorily perform internal fixation.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Patela
/
Fraturas não Consolidadas
Tipo de estudo:
Prognostic_studies
/
Systematic_reviews
Limite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Int Orthop
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos