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Management of comminuted extraarticular inferior pole patella fractures with partial patellectomy and patellar tendon repair by transosseous sutures

Konchada Srikant, Debasish Mishra, Vijoy Kumar Sinha, Sandeep Pradhan.


Abstract

Background: Lower pole patella fractures are not uncommon and are often comminuted and not amenable to traditional fixation methods as difficult to reduce and fix. Optimal method of treatment is still debatable. We present the results of managing such cases with the technique of partial patellectomy and patellar tendon repair by transosseous sutures.

Objective: To evaluate the outcome of comminuted inferior pole fractures of patella treated with partial patellectomy and patellar tendon repair by transosseous sutures.

Materials and Methods: In this prospective study between February 2014 and July 2016, we treated 12 patients, 10 were male and 2 were female. Postoperatively, knee was immobilized in knee brace with no flexion in 1st week; every next week then knee flexion was increased in the increments of 30 degree till 4 weeks postoperative. Quadriceps strengthening was then encouraged.

Results: Outcome at final follow-up was assessed with Bostman scoring system. Average Bostman score was 25.6. Excellent results were seen in 67% cases. One patient had an episode of superficial infection. There were no reports of rerupture and all patients returned to their preinjury activity level.

Conclusion: Partial patellectomy and patellar tendon repair using transosseus sutures is very effective method in the management of comminuted extraarticular inferior pole patella fractures which are not normally amenable to conventional fixation methods. It is simple and easier to perform with producible excellent results with no hardware related complications. Further studies are required to validate this technique with larger sample size and controls.

Key words: Inferior Pole Patella; Comminuted; Transosseous; Partial Patellectomy; Patellar Tendon






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