[Early evaluation of surgical treatment for patella fractures]

From mars 1989 to mars 1992, 26 fractures of the patella were treated surgically in the "Orthopaedic and Traumatological center in Dakar". We have evaluated the functional and the anatomical results. The mean age of the patients was 45 years. The most common mechanism was direct trauma (24 cases). We have registered 12 opened fractures, 24 displaced fractures and 13 comminutive fractures. Surgical methods were modified tension band internal fixation (18 cases), tension band wiring for fixation (5 cases) and circumferential wire loop fixation (3 cases). The mean follow-up was ten months. Only eight patients have adequate post-operative kinesitherapy. So functional results was poor in 50% of cases. The anatomical reconstruction of the patella were achieved in 18 cases. We have observed a relation between: anatomical results and inadequate indications; excellent functional results and adequate kinesitherapy. So the authors recommend modified tension band internal fixation in transversal fractures and fracture with central communication. Tension band wiring for fixation is used in others comminutive fractures. Post operative kinesitherapy must be realized in a adequate center and criteria of functional evaluation be wider theses.