Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing

Oh, Hyoung Keun; Choo, Suk Kyu; Kim, Ji Wan; Lee, Mark A.

doi:10.1016/j.injury.2015.09.026

Cited by 39 publications

(51 citation statements)

References 12 publications

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“…The construct allows stable fixation, allows fixation in all planes, rigid stabilization, osseous union of the comminuted fragment, early mobilisation, shorter recovery period, early weight bearing, and decrease knee stiffness, reduction in chances of non unions and complications and improved functional outcome and preventing early onset patellofemoral arthrosis [16] . In our study we has one device complication where the implant was sitting on the inferior pole and patient sustained a fall post-operative 8 months and had ligamentum patella rupture which has to be treated surgically [19] . Limitation of the study is short term follow up not known long term complications and smaller study group.…”

Section: Discussionmentioning

confidence: 94%

“…The primary disadvantage is the repetitive motion can lead to failure of reduction and rupture of the wire if there is too much tensioning and implant back out causing pain and upwards migrations of the wire irritating the quadriceps bulk or impinging on the patellar tendon thus causing delayed recovery and poor function leading to a requirement of another procedure. TBW still serves as a widely used and accepted method for treating fracture patella; hence we use a technique where we improve the fixation by adding a small fragment plate [5][6][7][8][9][10][11][12][19][20][21] . Our technique is doing a tension band wiring with augmentation plate, we use a low profile plate system with TBW to fix the comminuted fracture which do not give a satisfactory result using only TBW.…”

Section: Discussionmentioning

confidence: 99%

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A study of functional and clinical outcome for augmentation plating with tension band wiring for complex patella fractures

Joshi¹,

Kulkarni²,

Kulkarni³

et al. 2020

Int. J. Orthop. Sci.

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Background: Tension Band wiring is a standard age-old technique used for treating simple fracture patella. However comminuted fracture patella treated only with tension band wiring the results were not satisfying as the rigid and anatomical fragment fixation was not possible. Here we describe a newer method of using a low profile plate along with the standard tension band wiring for treating the comminuted fracture patella with the aim of getting anatomic and rigid fixation and good function. The purpose of this prospective study is to determine the effectiveness of this technique of augmentation plate with tension band wiring used in comminuted patella fracture and its effect on functional and clinical outcome. Methods: Between Jan 2015 and May 2019, 30 patients with displaced comminuted fracture of patella were included in the study. All the patients underwent fixation of fracture of patella with low profile plate and tension band wiring. The knee function of the patients and status of the patient were determined using Lysholm knee score and KOS score. Results: The average follow up period was 12-15 months. At 12 months follow up bone healing was satisfying in all the patients and the average range of motion was 0-120 degree at the end of 12 months. Score Lysholm knee scale: The results were excellent in 21patients, good in 8 patients and 1 patient with rupture of ligamentum patellae had gradual (excellent) results. One patient had complication with ligamentum patellae rupture on subsequent fall at 8 th month and required resurgery and repair for the same. Conclusions: The technique of augmentation plate is as effective and safe for treating complex comminuted fracture patella with excellent clinical outcome and results.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

A study of functional and clinical outcome for augmentation plating with tension band wiring for complex patella fractures

Joshi¹,

Kulkarni²,

Kulkarni³

et al. 2020

Int. J. Orthop. Sci.

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“…Oh H. and Song H. also tried to avoid patellectomy and used vertical wiring for fractures of the inferior pole. However, they did not fix the patella with an additional wire loop [14,15].…”

Section: Resultsmentioning

confidence: 99%

Outcomes after operative treatment of patella fractures

Хиджазин¹,

Solod²,

Абдулхабиров³

2020

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Introduction Patella fractures account for one percent of all fractures. Arthritis, non-union and other complications which affect the function of the lower limb may develop in the long term. The aim was to develop the most optimal osteosynthesis techniques for patella fractures. Methods We analyzed long-term treatment results of 78 patients with patella fractures treated from 2017 to 2018 using the KOOS (The Knee Injury and Osteoarthritis Outcome Score) scale, clinical examinations and knee joint X-rays. Based on the methods of surgical treatment for patella fractures, we divided the patients into 5 groups: Weber tension band wiring for two-fragment fractures; cross-like osteosynthesis and other methods of patella osteosynthesis using K-wires and wire loops for multifragmental fractures of the patella; combined osteosynthesis (tension band wiring with an additional screw or cerclage around patella); partial patellectomy and the inferior pole osteosynthesis. Results A comparative analysis of patients' groups after surgical treatment of patella fractures using the KOOS scale showed the best results after Weber tension band wiring for transversal fractures (72 %). The results of patients with multifragmental fractures of the patella using K-wires and wire loops were positive in 64 %; after the restoration of the inferior pole in 68 %, after partial patellectomy in 57 %. Conclusion For transversal fractures of the patella, tension band wiring is the method of choice. With multifragmental patella fractures, good results are achieved by cross-like osteosynthesis and other methods using K-wires and wire bands. The use of patellectomy followed by wire loop locking should be avoided for all types of patella fractures. In fractures of the inferior pole of the patella, it is preferable to fix it to the main patella fragment.

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“…Similarly once arthritis was excluded, unsatisfactory outcome of inferior pole fractures (mean 18.85) improved to a good score (mean 23.3). Inferior pole patella fractures are very difficult to fix and those treated by excision has shown poor results when compared to internal fixation [25] . This technique we have used allows even these fractures to adequately fixed resulting in a good outcome.…”

Section: Discussionmentioning

confidence: 99%

Vertical and figure of eight fibre wiring for patella fractures

George¹,

George²,

Chittaranjan³

et al. 2017

Int. J. Orthop. Sci.

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Background: Displaced patella fractures need to be treated by internal fixation for achieving good outcome. Metallic hardware related pain and irritation are one among the many reasons for reoperations. Fracture displacement can happen due to early mobilisation depending on bone quality and fracture pattern. The aim of our study was to evaluate the postoperative outcome and complication rates of patella fractures fixed with fibre wires in a vertical and figure of eight pattern. Methods: We retrospectively followed up all patella fractures fixed using fibre wires utilising Krackow stitches through patellar tendon, longitudinal fixation through fracture fragments and figure of eight wiring on anterior patella. We evaluated their clinical outcome, range of movement, time to union and complication rates. We also evaluated these for arthritic scenario and different fracture patterns. Results: We had 22 patients (mean age 50.7) with a mean follow up of 22.7 months, mean Bostman score of 23.5, mean range of movement 115 0 and mean time to union 13.5 weeks. Arthritic patients though united without any complications had an unsatisfactory score. None of the patients developed any hardware related complications, fracture displacement or needed an implant removal. Conclusion: Fibre wires can be used in vertical and figure of pattern for achieving fracture union with good clinical outcome without fracture displacement or symptomatic hardware problems.

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Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing

Cited by 39 publications

References 12 publications

A study of functional and clinical outcome for augmentation plating with tension band wiring for complex patella fractures

A study of functional and clinical outcome for augmentation plating with tension band wiring for complex patella fractures

Outcomes after operative treatment of patella fractures

Vertical and figure of eight fibre wiring for patella fractures

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