Comminuted fracture of patella treated by primary Ilizarov external fixation: a case report

Authors

  • Godhasiri Ponugoti Department of Orthopaedics, Ramaiah Medical College, Bangalore, Karnataka, India
  • Harshad Mohanlal Shah Department of Orthopaedics, Ramaiah Medical College, Bangalore, Karnataka, India
  • Sandeep Reddy Department of Orthopaedics, Ramaiah Medical College, Bangalore, Karnataka, India
  • Namratha C. Kolsur Department of Orthopaedics, Ramaiah Medical College, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20202701

Keywords:

Patella fracture, Comminuted fracture Patella, Ilizarov fixation of patella, External fixation for patella fractures

Abstract

Tension band wiring (TBW) is the conventional procedure for transverse patellar fractures. Comminuted fractures of patella are difficult to treat by TBW. Routine osteosynthesis procedures are prone for infection, implant failure and symptomatic hardware in such cases. We are reporting a case of comminuted patellar fracture in a 62 years old lady treated by Ilizarov external fixator. Patient presented with h/o fall and injury to right knee. There was swelling of the right knee. She was unable to bear weight and move her knee. Radiograph revealed a comminuted patellar fracture. Pre-operative evaluation was done. Ilizarov external fixation was done under spinal anaesthesia with one half ring and 5 trans osseous Ilizarov wires. The patient was allowed full weight bearing. Knee ROM was allowed. The fixator was removed after 4 months and physiotherapy continued. The patient was followed up for 3 years. She has full range of knee movements and is able to squat and sit cross-legged and the radiographs show good union. The Ilizarov external fixator in this case helped us to treat a comminuted fracture without opening of the fracture site and has prevented complications.

Author Biographies

Godhasiri Ponugoti, Department of Orthopaedics, Ramaiah Medical College, Bangalore, Karnataka, India

DEPARTMENT OF ORTHOPAEDICS

LIMB LENGTHENING AND DEFORMITY CORRECTION FELLOW

Harshad Mohanlal Shah, Department of Orthopaedics, Ramaiah Medical College, Bangalore, Karnataka, India

SENIOR PROFESSOR
DEPARTMENT OF ORTHOPAEDICS

Sandeep Reddy, Department of Orthopaedics, Ramaiah Medical College, Bangalore, Karnataka, India

DEPARTMENT OF ORTHOPAEDICS

ASSISTANT PROFESSOR

Namratha C. Kolsur, Department of Orthopaedics, Ramaiah Medical College, Bangalore, Karnataka, India

INTERN

DEPARTMENT OF ORTHOPAEDICS

RAMAIAH MEDICAL COLLEGE AND HOSPITALS

References

Bostrom A. Fracture of the patella. A study of 422 patellar fractures. Acta Orthop Scand Suppl. 1972;143:1-80.

Luo TD, Pilson H. Fracture, Patella. Treasure island, FL: Stat pearls; 2018.

Shabat S, Mann G, Kish B, Stern A, Sagiv P, Nyska M. Functional results after patellar fractures in elderly patients. Arch Gerontol Geriatr. 2003;37(1):93-8.

Matthews B, Hazratwala K, Rosa BS. Comminuted Patella Fracture in Elderly Patients: A Systematic Review and Case Report. Geriatr Orthop Surg Rehabil. 2017;8(3):135-44.

Kastelec M, Veselko M. Inferior patellar pole avulsion fractures: osteosynthesis compared with pole resection. J Bone Joint Surg Am. 2004;86(4):696-701.

Hoshino M, Tran C, Tiberi WV, Black J, Mary HL, Bonnie MG, et al. Complications Following Tension-Band Fixation of Patellar Fractures with Cannulated Screws Compared with Kirschner Wires. J Bone Joint Surg. 2013;95:653-9.

Ilizarov GA. Trans osseous osteosynthesis. Berlin etc: Springer -Verlag; 2000: 429-432.

Maioochi AB. Treatment of Intra-articular fractures. In Operative Principles of Ilizarov by ASAMI group. Baltimore, Maryland, USA: Williams and Wilkins; 1991: 172.

Baruah R. Modified Ilizarov in difficult Fracture of the Patella. A case reports. J Orthopaedic Case Reports. 2016;6:26-8.

Wardak MI, Siawash AR, Hayda R. Fixation of patella fractures with a minimally invasive tensioned wire method: Compressive external fixation. J Trauma Acute Care Surg. 2012;72(5):1393-8.

Bari MM, Shetu NH, Rahman M, Munshi MH. Treatment of patella fractures by compressive external fixation. MOJ Orthop Rheumatol. 2015;2(6):70.

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Published

2020-06-23

Issue

Section

Case Reports