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. 2015 Sep;6(3):207-11.
doi: 10.1016/j.jcot.2015.03.009. Epub 2015 Apr 23.

A novel technique of patella fracture fixation facilitating early mobilization and reducing re-operation rates

Sanjay Agarwala  1 , Pranshu Agrawal  1 , Anshul Sobti  1
Affiliations

A novel technique of patella fracture fixation facilitating early mobilization and reducing re-operation rates

Sanjay Agarwala et al. J Clin Orthop Trauma. 2015 Sep.

Abstract

Objective: Fractures of patella constitute 1% of all fractures. Various techniques have been described for internal fixation of patella fractures. Superiority of one technique over the other has long been debated. We reviewed a series of fifty-one patients with transverse or comminuted fractures of patella treated with a novel technique to assess if it had any advantages over the existing methods of fixation.

Design: Retrospective.

Setting: A tertiary care centre.

Patients & methods: Fifty-one patients with patella fracture OTA 34C, with a mean age of 39 years (range 18-61) were treated with technique of cerclage and two tension bands at our institute. Forty-eight patients completed the study.

Main outcome measurements: Range of Motion and evidence of radiological union were assessed at regular follow-ups.

Results: Forty-four out of forty-eight patients had gained up-to 90 degrees of active flexion at the end of 1 week. Two patients (4.2%) developed superficial infection. All fractures had united at the end of 12 weeks. Five patients (10.3%) underwent a second surgery; four (8.3%) due to implant related complications. Malunion or non-union was not noted in any of the cases.

Conclusion: The advantages of the described method are early mobilization, elimination of k-wire related complications, and ease of use in comminuted fracture pattern as well and a lower reoperation rates as compared to the available literature. We strongly recommend its use in cases of displaced comminuted/transverse fractures of patella as an alternate method of treatment.

Level of evidence: Level III.

Keywords: Cerclage wiring; Patella fracture; Tension band; k-wire related complications.

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Figures

Fig. 1
Fig. 1
Showing the railroad technique of inserting cerclage wire.
Fig. 2
Fig. 2
Showing anterior tension band in box pattern.
Fig. 3
Fig. 3
Showing anterior tension band in figure of 8 pattern.
Fig. 4
Fig. 4
Clinical photograph of range of extension at 12 weeks follow-up.
Fig. 5
Fig. 5
Clinical photograph of range of flexion at 12 weeks follow-up.
Fig. 6
Fig. 6
Preoperative radiograph of patella fracture in a 46 year female.
Fig. 7
Fig. 7
Twenty-four hours postoperative radiograph of patella fracture in a 46 year female.
Fig. 8
Fig. 8
Radiograph showing union at 12 weeks in patella fracture in a 46 year female.
See this image and copyright information in PMC

References

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