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Open reduction internal fixation of displaced transverse patella fractures with figure-eight wiring through parallel
1New Hampshire Bone & Joint Institute, Bedford, NH 03110, USA.
Objective:
To evaluate the clinical results of transverse patella fracture fixation with a tensioned anterior figure-eight wire placed through parallel cannulated screws.
Design:
Prospective, clinical.
Patients:
Ten patients with displaced transverse patella fractures were managed with a standardized rehabilitation protocol that employed early continuous passive knee motion.
Outcome Measures:
Time to clinical and radiographic union, Hospital for Special Surgery Knee Scores, and comparisons with literature cohort studies.
Results:
Clinical union occurred at an of average eight weeks and radiographic union at a mean of thirteen weeks postoperatively. Early continuous passive motion over a restricted are did not compromise the quality of fracture reduction, even though the majority of patients were elderly and had osteopenic bone. Subjective and functional results using Hospital for Special Surgery Knee Scores were comparable to previously published reports, with 70 percent achieving an excellent or good outcome.
Conclusions:
The described fixation technique for transverse patella fractures had clinical results equivalent to reports of patella fractures fixed with modified tension band wiring. Advantages included a low-profile construct that caused lesser degrees of implant irritation to local soft tissue structures, was compatible with the use of early restricted motion, and afforded a method to salvage three cases in which traditional tension band wiring failed to maintain an anatomic reduction in oteoporotic bone.