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. 2021 Jan 1;35(1):e1-e6.
doi: 10.1097/BOT.0000000000001868.

Functional Outcomes of Patella Fractures Treated With Anterior Plate Osteosynthesis at One Year

Stephen J Shymon  1 , Hayley Jansson, Brian A Schneiderman, Alexander Nazareth, Christopher Max Hoshino, Daniel M Zinar, Stuart M Gold
Affiliations

Functional Outcomes of Patella Fractures Treated With Anterior Plate Osteosynthesis at One Year

Stephen J Shymon et al. J Orthop Trauma. .

Abstract

Objectives: To evaluate the functional outcomes of patients with displaced patellar fractures treated with anterior plate constructs.

Design: Prospective cohort and retrospective clinical and radiographic assessment.

Setting: Level I Trauma Center.

Patients/participants: Between 2014 and 2018, 18 patients who underwent operative intervention for an isolated, displaced patella fracture (OTA/AO 34C1-3) with a minimum of 1-year follow-up agreed to participate in the study. The mean follow-up was 19.5 ± 6.0 months.

Intervention: Patients were treated with 2.4 or 2.7-mm plates and supplemental screws or cerclage wires.

Main outcome measurements: Patients were evaluated with the Short Form-36 Survey and the Knee Injury and Osteoarthritis Outcome Scores and asked about symptomatic implants. The range of motion was assessed by goniometer.

Results: The cohort had no wound complications, infections, nonunion, loss of reduction, or implant failure. Active knee flexion was 131 ± 7 degrees. Five patients (28%) endorsed implant irritation. Only one patient (5.5%) underwent implant removal, which consisted of transverse screw removal alone. Twelve of the 14 patients (86%), who were previously employed, returned to work at 10 ± 7 weeks. All Knee Injury and Osteoarthritis Outcome Scores subscale scores and the Short Form-36 Survey scores for physical functioning, limitations due to physical health, limitations due to mental health, and social functioning were significantly lower than reference population norms (P < 0.05).

Conclusions: Anterior plating provides reliable fixation for displaced patellar fractures and results in a low incidence of implant irritation. However, patients who had anterior fixation for displaced patella fractures continue to exhibit functional deficits at 1-year postoperatively.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

C. M. Hoshino—Consultant/Educator for Stryker, Smith and Nephew, Orthofix, and Globus. S. M. Gold—Consultant/Educator for Stryker, Smith and Nephew, and Orthofix. The remaining authors report no conflict of interest.

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