DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20211602

Functional outcome of surgical management in cases of fracture patella in a tertiary care hospital in Salem

Nikhilesh P. S., Hari Sivanandan, Anandanarayan M., A. E. Manoharan

Abstract


Background: Fractures of the patella are serious injuries with a broad range of subtypes. These injuries account for about 1% of all skeletal injuries and are most prevalent within the age group of 20-50 years. The underlying mechanisms of open fractures are mostly high-velocity accidents. To assess the functional outcome of various surgical procedures done for fracture patella.

Methods: A longitudinal study was conducted from the department of orthopedics, Vinayaka missions Kirupananda Variyar medical college and hospital, Salem for one year in August 2019 and July 2020. All the adult patients admitted with the diagnosis of patellar fracture were included in the study. A complete local examination was conducted and an X-ray of AP and the lateral view was taken for all the patients.

Results: Transverse patella fracture is being the most common fracture and for that modified tension band wiring (TBW) was the most common procedure performed and for comminuted fracture partial patellectomy was the most common procedure and for 1 patient total patellectomy was performed.

Conclusions: The study shows that the treatment of patella fractures with modified tension band wiring is a definitive treatment with minimal complications and excellent functional outcomes.


Keywords


Patella fracture, Tension band wiring, West criteria, Functional outcome

Full Text:

PDF

References


Wild M, Windolf J, Patellafrakturen FS. Fractures of the patella. Unfallchirurg. 2010;113(5):401-11.

Lotke PA, Ecker ML. Transverse fractures of the patella. Clin Orthop Relat Res. 1981;(158):180-4.

Nummi J. Fracture of the patella. A clinical study of 707 patellar fractures. Ann Chir Gynaecol Fenn Suppl. 1971;179:1-85.

Scolaro J, Bernstein J, Ahn J. Patellar fractures. Clin Orthop Relat Res. 2011;469(4):1213-5.

Torchia ME, Lewallen DG. Open fractures of the patella. J Orthop Trauma. 1996;10(6):403-09.

Nomura E, Inoue M, Kurimura M. Chondral, and osteochondral injuries associated with acute patellar dislocation. Arthroscopy. 2003;19(7):717-21.

Ortiguera CJ, Berry DJ. Patellar fracture after total knee arthroplasty. J Bone Joint Surg Am. 2002;84-A(4):532-40.

Berg EE. Management of patella fractures associated with central third bone-patella tendon-bone autograft ACL reconstructions. Arthroscopy. 1996;12(6):756-9.

Bonus TJ, Alexander AH. Patellar fracture and avulsion of the patellar ligament complicating arthroscopic anterior cruciate ligament reconstruction. Orthop Rev. 1991;20(9):770-74.

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

Atesok K, Doral MN, Lowe J, Finsterbush A. Symptomatic bipartite patella: Treatment alternatives. J Am Acad Orthop Surg. 2008;16(8):455-61.

Wiberg G. Roentgenographs and anatomic studies on the femoro-patellar joint: with special reference to chondromalacia patellae. Acta Orthop Scand. 1941;12:319-410.

Scapinelli R. Blood supply of the human patella. Its relation to ischaemic necrosis after a fracture. J Bone Joint Surg Br. 1967;49-B:563-70.

Shim SS, Leung G. Blood supply of the knee joint: A microangiographic study in children and adults. Clin Orthop Relat Res. 1986;208:1196.

Scolaro J, Bernstein J, Ahn J. Patellar fractures. Clin Orthop Relat Res. 2011;469(4):1213-5.

Kaufer H. Mechanical function of the patella. J Bone Joint Surg Am. 1971;53(8):1551-60.

Goldstein SA, Coale E, Weiss AP, Grossnickle M, Meller B, Matthews LS. Patellar surface strain. J Orthop Res. 1986;4(3):372-7.

Kaufer H. Mechanical function of the patella. J Bone Joint Surg Am. 1971;53(8):1551-60.

Koval KJ, Kim YH. Patella fractures. Evaluation and treatment. Am J Knee Surg. 1997;10(2):101-8.

Huberti HH, Hayes WC, Stone JL, Shy but GT. Force ratios in the quadriceps tendon and ligament patellae. J Orthop Res. 1984;2(1):49-54.

Bostrom MP, Asnis SE, Ernberg JJ, Wright TM, Giddings VL, Berberian WS, Missouri AA. Fatigue testing of cerclage stainless steel wire fixation. J Orthop Trauma. 1994;8(5):422-8.

Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of internal fixation, 2nd edn. Springer, Berlin Heidelberg New York. 1979;42-7.

Carpenter JE, Kasman R, Matthews LS. Fractures of the patella. J Bone Joint Surg Am. 1993;75:1550-61.

Scolaro J, Bernstein J, Ahn J. Patellar fractures. Clin Orthop Relat Res. 2011;469(4):1213-5.

Bumbaširević M, Lešić A. Acute injuries of the extensor mechanism of the knee. Current Orthop. 2005;19:49-58.