Interventions for treating fractures of the patella in adults

Filho, Jorge Sayum; Lenza, Mário; Carvalho, Rogério Teixeira de; Pires, Osvaldo Guilherme Nunes; Cohen, Moisés; Belloti, João Carlos

doi:10.1002/14651858.cd009651.pub2

Cited by 25 publications

(12 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a recent Cochrane review it was noted that percutaneous osteosynthesis may give better results than conventional open surgery, with biodegradable implants faring no better than metallic ones for displaced fractures and that patellectomy combined with vastus medialis advancement may be better than simple patellectomy. However the authors noted that available trials had small numbers of patients, emphasising the need for randomised controlled trials and that specific treatment options should be chosen on an individual patient basis [48].…”

Section: Complicationsmentioning

confidence: 99%

Adult native knee extensor mechanism ruptures

Pengas

Assiotis

Khan

et al. 2016

Injury

View full text Add to dashboard Cite

Extensor mechanism rupture is a serious event requiring prompt diagnosis and treatment. Patella fractures are reportedly six times more frequent than soft tissue injuries such as quadriceps or patella tendon ruptures. Classically quadriceps and patella tendon ruptures are seen more in males, with those over 40 predominantly suffering from quadriceps tendon ruptures, often associated with an underlying condition, whereas patella tendon ruptures are mostly associated with sport injuries and are commonly seen in the under 40s. Almost all types of extensor mechanism ruptures benefit from early management which typically involves surgery. Diagnosis can be deemed easy to make by demonstrating inability to actively extend the knee, this however can be easily overlooked and missed in a busy emergency department leading to a late diagnosis and necessitating more complex surgery. Earlier surgical intervention and rehabilitation tend to produce improved outcomes.

show abstract

Section: Complicationsmentioning

confidence: 99%

Adult native knee extensor mechanism ruptures

Pengas

Assiotis

Khan

et al. 2016

Injury

View full text Add to dashboard Cite

show abstract

“…). At full text nine primary articles, 28 systematic review (SR) articles and 18 guidelines were included.…”

Section: Resultsmentioning

confidence: 99%

Review article: Best practice management of common knee injuries in the emergency department (part 3 of the musculoskeletal injuries rapid review series)

Strudwick

McPhee

Bell

et al. 2017

Emerg Medicine Australasia

View full text Add to dashboard Cite

Knee injuries are a common presentation to the ED and are often difficult to assess and definitively diagnose due to the patient's acute pain, effusion and guarding. The quality of ED care provided to patients with fractures or soft tissue injuries of the knee is critical to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common knee injuries in the ED. Databases were searched in 2017, including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites. Primary studies, systematic reviews and guidelines were considered for inclusion. English-language articles published in the past 12 years that addressed the acute assessment, management, follow-up plan or prognosis were included. Data extraction of included articles was conducted, followed by quality appraisal to rate the level of evidence where possible. The search revealed 2250 articles, of which 54 were included in the review (n = 8 primary articles, n = 28 systematic reviews, n = 18 guidelines). This rapid review provides clinicians managing fractures and soft tissue injuries of the knee in the ED, a summary of the best available evidence to enhance the quality of care for optimal patient outcomes. There is consistent evidence to support undertaking a thorough history and physical examination, including the application of special tests and clinical decision rules for imaging. In the undifferentiated knee injury, expedited follow up and further imaging is recommended to improve patient outcomes and cost-effectiveness.

show abstract

“…10 Surgery is the preferred treatment for displaced patellar fractures and many surgical procedures with different fixation devices have been used, such as staples, locking plates, and other devices used in combination with tension-band wiring, however, current evidence is limited for guiding the management of patellar fracture. 16 Tension-band wiring is the most widely used technique, and has produced satisfactory outcomes. 3 Forces acting at the fracture site following fixation include either a tensile force, due to the action of the quadriceps in extension, or 3-point bending that occurs during knee flexion.…”

Section: Discussionmentioning

confidence: 99%

Modified two-tension-band for patellar fractures

2019

View full text Add to dashboard Cite

Objective To compare a modified two-tension-band (MTTB) technique with the AO tension band in treating patellar fractures. Methods This retrospective study included patients treated with AO tension band (group 1) or MTTB (group 2). Data obtained during serial follow-up evaluations of time to bony union, range of motion (ROM), Hospital for Special Surgery (HSS) score and complication rates, were analysed. Results Fractures healed in all 51 patients included in the study (group 1, n = 28; group 2, n = 23), with no statistically significant between-group difference in time to bony union. Regarding function results, group 2 had better HSS scores at 3 and 6 months postoperatively; however, at 1 year postoperatively, both groups had similar HSS scores and achieved acceptable flexion and ROM. The overall complication rate was significantly lower in group 2, but average costs were higher in group 2 versus group 1. Conclusion MTTB provides secure fixation and improved knee function at 3 and 6 months postoperatively, and has a lower complication rate with early mobilization, compared with the AO tension-band technique.

show abstract

Interventions for treating fractures of the patella in adults

Cited by 25 publications

References 39 publications

Adult native knee extensor mechanism ruptures

Adult native knee extensor mechanism ruptures

Review article: Best practice management of common knee injuries in the emergency department (part 3 of the musculoskeletal injuries rapid review series)

Modified two-tension-band for patellar fractures

Contact Info

Product

Resources

About