Migration to the popliteal fossa of broken wires from a fixed patellar fracture

Choi, Heeyoul; Min, Kyung-Dae; Choi, Sang-Wook; Lee, Byung-Ill

doi:10.1016/j.knee.2008.06.005

Cited by 39 publications

(26 citation statements)

References 12 publications

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“…No evidence of posttraumatic arthritis or progression of preexisting degenerative patellofemoral joint osteoarthritis was observed. At the final follow-up, Böstman knee scores were excellent in 88 cases (28)(29)(30), good in 55 (20)(21)(22)(23)(24)(25)(26)(27), and unsatisfactory in 13 (<20). According to SF-36 evaluation, the average score was 84.5 (range, 62-91).…”

Section: Resultsmentioning

confidence: 92%

“…In cases of comminuted patellar fractures, however, the tensionband technique may not offer adequate stabilization of multiple fragments and necessitate additional cerclage wiring. Additionally, a 12 to 22% loss of fixation has been reported in the early postoperative period 3,21,22 with penetration or excursion of K-wire tips and knots into soft tissue that were related to symptomatic hardware. 23,24 Inferior patellar pole fractures constitute another challenge to orthopedic fixation.…”

Section: Discussionmentioning

confidence: 99%

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Application of a Shape-Memory Alloy Concentrator in Displaced Patella Fractures: Technique and Long-Term Results

et al. 2016

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Operative treatment is usually recommended in displaced patella fractures. Several techniques have been advocated for internal fixation of patella fractures. Despite the relatively good clinical outcomes that have been demonstrated in many studies, postoperative morbidities such as fixation failure, nonunion, infection, and knee stiffness are not uncommon. We present a new alternative treatment technique for displaced patellar fractures. Between April 1995 and May 2005, we used the Nitinol Patella Concentrator (NTPC) to treat 156 consecutive patients with displaced patellar fractures. Injuries arose from vehicular accidents in 56 (35.9%) cases, direct falls onto the knee in 85 (54.5%) cases, and sports injuries in 15 (9.6%) cases. The mean patient age was 46.3 years (range, 25-77 years). Clinical assessments were made using the Böstman knee score and the MOS SF-36 questionnaire (Medical Outcomes Study 36-item short-form health survey), which were both recorded at the final follow-up visit. The mean follow-up was 7.3 years (range, 6-17 years). At the final follow-up, the Böstman knee scores were excellent in 88 cases (28-30), good in 55 (20-27), and unsatisfactory in 13 (<20). According to the MOS SF-36 evaluation, the average score was 84.5 (range, 62-91). Treatment of patellar fracture with the NTPC not only may serve as an effective and rigid fixation method in multifragmented displaced and inferior pole fractures, but also may provide continuous concentrative compression during the osseous healing process. Thus, use of the NTPC may help restore the functional integrity of the extensor mechanism and permit early rehabilitation with a lower incidence of postoperative complications.

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Section: Resultsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Application of a Shape-Memory Alloy Concentrator in Displaced Patella Fractures: Technique and Long-Term Results

et al. 2016

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“…Theoretical routes of metal hardware migration include paths along myofascial planes and even into the circulation. After patellar fracture, pins are reported to migrate into the popliteal fossa, [3]and to the heart. [4] Only two cases of intra-articular migration of wires from patella to the knee joint have been documented in literature.…”

Section: Discussionmentioning

confidence: 99%

“…[1,2]Wire migration into the popliteal fossa and the right ventricle have been reported secondary to implant failure. [3,4]The migration of a broken k-wires into the knee joint is a potential destroying complication which has been rarely reported in literature. [5,6]We here report a case of a 38 year old man …”

Section: Introductionmentioning

confidence: 99%

Severe iatrogenic knee arthrosis caused by a delayed intra-articular migration of a broken k-wire. A potential destroying complication of patella tension band wiring

Carbone

Arceri

Canero

et al. 2014

J Minim Invasive Orthop

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Citation: Carbone S, Arceri V, Canero G, Gumina S. Severe iatrogenic knee arthrosis caused by a delayed intraarticular migration of a broken k-wire. A potential destroying complication of patella tension band wiring. J Minim Invasive Orthop, 2014, 1(5): e5. doi:10.15383/jmio.5. Competing interests:The authors have declared that no competing interests exist. Abstract: Patella fractures are relatively common injuries. Tension band wiring is often used to treat displaced patella fracture. Wire breakage and migration is a well-known complication of using a wire tension band construct. Conflict of interest: NoneWe report a case of intra-articular migration of a broken k-wire used for patella tension band wiring two years after fixation and noted six months after the last radiological examination. The broken wire was removed arthroscopically and remaining hardware via three mini-incision of the skin. The knee joint developed severe iatrogenic arthrosis. We would like to show that broken hardware can migrate also into the joint and that it can rapidly cause severe knee arthrosis, a detrimental complication rarely described in literature. Implant removal at fracture healing or close clinical and radiological examination after internal fixation are mandatory to avoid such complication.

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“…1 Instances of late hardware failure have also been published, with case reports describing migration of hardware into the popliteal fossa and even the heart requiring cardiothoracic surgery for retrieval. 8,9 Nonunion/Delayed Union The incidence of nonunion or delayed union in closed, operatively treated patella fractures is rare, with one series noting a rate of < 1%. 6 Thus, there is limited evidence in the literature with regard to the management of these challenging problems.…”

Section: Fixation Failurementioning

confidence: 99%

Complications of Patellar Fracture Repair: Treatment and Results

2013

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Open reduction and internal fixation (ORIF) of patellar fractures generally leads to good results; however, the potential for surgical complications exists. Nonunion, infection, posttraumatic arthritis, arthrofibrosis, symptomatic hardware, and extensor mechanism insufficiency have all been described following patellar ORIF, and the risk of their occurrence may be augmented by patient-, injury-, and treatment-related factors. When complications arise, advanced reconstructive techniques are often required for successful management. This review will report the incidence of the aforementioned complications, highlight risk factors contributing to their frequency, discuss treatment options, and present the reported results of selected treatment strategies from available literature.

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Migration to the popliteal fossa of broken wires from a fixed patellar fracture

Cited by 39 publications

References 12 publications

Application of a Shape-Memory Alloy Concentrator in Displaced Patella Fractures: Technique and Long-Term Results

Application of a Shape-Memory Alloy Concentrator in Displaced Patella Fractures: Technique and Long-Term Results

Severe iatrogenic knee arthrosis caused by a delayed intra-articular migration of a broken k-wire. A potential destroying complication of patella tension band wiring

Complications of Patellar Fracture Repair: Treatment and Results

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