To plate, or not to plate? A systematic review of functional outcomes and complications of plate fixation in patellar fractures

Tsotsolis, Stavros; Ha, Joon; Fernandes, Ana; Park, Jae Yong; Dewhurst, Matthew; Walker, T.G.; Ilo, Kevin; Park, Se Ri; Patel, Amit; Hester, Thomas; Poutoglidou, Frideriki

doi:10.1007/s00590-023-03597-9

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…In a biomechanical study conducted by Wagner FC et al [ 31 ], osteosynthesis with an anterior locking plate was compared with cannulated screws with tension band wiring in comminuted patellar fractures. The results indicated that plates provided better primary stability in this context.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, Tsotsolis S. et al [ 31 ] reported a 10.44% complication rate associated with the use of plates for patellar fractures, a lower figure compared to osteosynthesis with cerclage. Cerclage fixation combined with hook plate, according to Gu et al [ 22 ], has been revealed as a reliable method for managing fractures of the lower patellar pole, allowing immediate rehabilitation and weight-bearing.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of metatarsal hook plates in the treatment of multifragmentary patellar fractures - A case series

Barros,

Ballesteros,

Noboa

et al. 2024

Trauma Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of metatarsal hook plates in the treatment of multifragmentary patellar fractures - A case series

Barros,

Ballesteros,

Noboa

et al. 2024

Trauma Case Reports

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“…The findings suggest that open reduction and internal fixation (ORIF) with plating for patellar fractures is a safe alternative, associated with a lower complication and reoperation rate compared to tension band wiring (TBW). The authors emphasize the need for future randomized prospective studies to validate the results of this systematic review [ 87 ].…”

Section: Comparison Of Techniquesmentioning

confidence: 99%

Evolution in the Management of Patella Fractures

Baid,

Narula,

Manara

et al. 2024

JCM

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Patella fractures usually occur as a result of direct trauma to the anterior knee joint, indirect injury as a result of eccentric muscle contraction, or rapid knee flexion against a contracted quadriceps muscle. The patella functions as part of the extensor mechanism of the knee, where large forces are transmitted, and its subcutaneous nature has made treatment of patella fractures a challenge. In this review article, we evaluate how the management of these fractures has evolved over time and the advantages associated with the various treatment techniques. There are few comparative studies looking at the different treatment types for fractures of the patella, with the goal of achieving a functional extensor mechanism with low rates of post-traumatic arthritis and metal-work irritation.

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Analysis of postoperative complications 5 years after osteosynthesis of patella fractures—a retrospective, multicenter cohort study

Berninger,

Korthaus,

Eggeling

et al. 2024

Eur J Trauma Emerg Surg

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Purpose The study aims to investigate the influence of patient- and fracture-specific factors on the occurrence of complications after osteosynthesis of patella fractures and to compare knee joint function, activity, and subjective pain levels after a regular postoperative course and after complications in the medium term. Methods This retrospective, multicenter cohort study examined patients who received surgery for patella fracture at level 1 trauma centers between 2013 and 2018. Patient demographics and fracture-specific variables were evaluated. Final follow-up assessments included patient-reported pain scores (NRS), subjective activity and knee function scores (Tegner Activity Scale, Lysholm score, IKDC score), complications, and revisions. Results A total of 243 patients with a mean follow-up of 63.4 ± 21.3 months were included. Among them, 66.9% of patients underwent tension band wiring (TBW), 19.0% received locking plate osteosynthesis (LPO), and 14.1% underwent screw osteosynthesis (SO). A total of 38 patients (15.6%) experienced complications (TBW: 16.7%; LPO: 15.2%; SO: 11.8%). Implant-related complications of atraumatic fragment dislocation and material insufficiency/dislocation, accounted for 50% of all complications, were significantly more common after TBW than LPO (p = 0.015). No patient-specific factor was identified as a general cause for increased complications. Overall, particularly following complications such as limited range of motion or traumatic refracture, functional knee scores were significantly lower and pain levels were significantly higher at the final follow-up when a complication occurred. Implant-related complications, however, achieved functional scores comparable to a regular postoperative course without complications after revision surgery. Conclusion The present study demonstrated that implant-related complications occurred significantly more often after TBW compared to LPO. The complication rates were similar in all groups.

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To plate, or not to plate? A systematic review of functional outcomes and complications of plate fixation in patellar fractures

Cited by 5 publications

References 31 publications

Use of metatarsal hook plates in the treatment of multifragmentary patellar fractures - A case series

Use of metatarsal hook plates in the treatment of multifragmentary patellar fractures - A case series

Evolution in the Management of Patella Fractures

Analysis of postoperative complications 5 years after osteosynthesis of patella fractures—a retrospective, multicenter cohort study

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