Long-term outcomes after partial patellectomy in comminuted fractures - a clinical study

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomechanics

Background:

• Distal patella fractures, particularly comminuted ones, present surgical challenges.
• Partial patellectomy (PP) is a potential treatment option for these complex fractures.
• Long-term outcomes of PP for distal patella fractures require further investigation.

Purpose of the Study:

• To evaluate the long-term clinical and radiographic outcomes of partial patellectomy (PP) for comminuted distal pole patella fractures.

Main Methods:

• Retrospective review of 17 patients undergoing PP for distal patella fractures (1995-2005).
• Assessment of functional outcomes using range of motion (ROM) and Bostman Scoring.
• Evaluation of quadriceps strength via isokinetic dynamometry and patellar height using the Insall-Salvati (IS) ratio.

Main Results:

• Excellent (64.7%) or good (35.3%) functional outcomes reported in all 17 patients after an average 14.6-year follow-up.
• Full knee extension and average ROM of 125.1° achieved, with no significant difference in quadriceps strength compared to the contralateral knee.
• No postoperative complications (infection, arthritis, stiffness) observed, though a decreased IS ratio indicated patella baja.

Conclusions:

• Partial patellectomy (PP) is a safe, simple, and reliable procedure for distal patella fractures.
• PP provides good long-term clinical outcomes despite potential patellar height reduction (patella baja).
• PP serves as a satisfactory alternative treatment when anatomical reduction is difficult.