FRACTURAS COMPLEJAS DE RÓTULA:¿OSTEOSÍNTESIS CON BANDA DE TENSIÓN O PLACA BLOQUEADA?

Abstract

The gold Standard in the treatment of patella fractures is generally the tension band technique.Recently, the treatment of these fractures by means of plate osteosyntehsis has been implemented, obtaining good results, and a low rate of complications and reinterventions. GOAL: Evaluate the clinic, functional and radiologic results in patients with a complex patella fracture, comparing results of plate osteosynthesis treatment versus tension band. MATERIAL AND METHODOLOGY:Retrospective obvervational cohort study. A total of sixty patients with patella fracture were evaluated at Hospital General Universitario de Elche between 2015 and 2020, thirty by tension bands technique and the other thirty with plate osteosynthesis treatment. All the clinic, functional and radiologic results, as well as complication were registered and compared for both groups. RESULTS: The functional scales show no differences (LES p = 0.475, EVA p = 0.888, KOS-ADLS p = 0.327). Differences have been found (p <0.001) in relation to the extraction of osteosynthesis material (EMO) in patients operated on with BT (50% vs 0%). We identified more material failure in BT (37.5%) versus 0% in plate (p = 0.001). The flexion ranges were higher in the plate group (120.42º) compared to BT (110º) without statistically significant differences. There are no differences in relation to scarring, infection, stiffness, pseudoarthrosis, patella magna or low, loss of reduction or deep vein thrombosis. CONCLUSIONS: All the patients with patella fracture that were evaluated presented successful clinic and functional results. However, we found a lower rate of complication and reinterventions on the plate osteosynthesis treatment. In summary, it has been proved that plate osteosynthesis treatment is a successful holding method for complex patella fractures.