Abstract
IntroductionThe incidence of patella fracture is statistically low (0.5–1.5%) compared to other fractures of the extremities [Patella fractures 76(10):987–997, 2005]. In the latter research, patella fractures if treated surgically present an overall inferior functional outcome. Little is known about the influence of the postoperative patella height on the clinical outcome. Therefore, the aim of our study was to analyse the influence of the patella height on the patients’ functional outcome after surgery.MethodsIn this retrospective study the in-house trauma register of our level I University trauma center was screened for patients suffering patella fractures treated surgically. Patella height of the same patients was evaluated on lateral X-rays using the Insall–Salvati Ratio (ISR). The patients’ X-rays were analyzed at two time points for the ISR, whereas group A presents ISR data right after surgery and group B data at the latest follow up (minimum 6 weeks). The change of mean ISR at both time points was tested for significance. The functional outcome was measured by the “Munich Knee Questionaire” (MKQ). These MKQ results of different patella heights and fracture types were compared.ResultsThe screening of our in-house trauma register revealed 375 patients between the years 2003 and 2016. Out of these 54 patients (34f, 20 m) were enrolled. In detail the follow-up time for ISR between group A and B accounted for a mean of 503.8 ± 655.7 days. The MKQ was assessed at a mean of 1367.0 ± 1042.8 days after surgery. According to the AO-classification 10% AO.34 type B and 90% AO.34 type C fractures were found. Group A showed in 9.1% a patella baja and in 27.3% a patella alta compared to group B presenting 20.0% patella baja and 14.5% patella alta. There was no significant difference in functional outcome referring to the MKQ in patella alta (MKQ 69.0% ± 18.2) or baja (MKQ 67.1% ± 17.9) (p = 0.9). No significant functional difference between AO34.type B (MKQ 74.5% ± 11.0) and AO34.type C fractures (MKQ 64.0% ± 15.0) resulted (p = 0.1).ConclusionOur results demonstrate that different postoperative patella heights apparently do not influence the functional outcome in the short follow-up.
Highlights
The incidence of patella fracture is statistically low (0.5–1.5%) compared to other fractures of the extremities [Patella fractures 76(10):987–997, 2005]
The questionnaire was sent to 375 patients with patella fractures who were treated in our Level-I trauma center between the year 2003 and 2016
The enrolled patients presented with 10% AO.34 type B and 90% AO.34 type C fractures according to the AO classification. 50% of the cases were treated with tension band wiring, in 20% screw fixations, in 13.3% tension band wiring with screw fixation and in 6.6% locking plate fixation (Starplate®, Arthrex) was performed
Summary
The incidence of patella fracture is statistically low (0.5–1.5%) compared to other fractures of the extremities [Patella fractures 76(10):987–997, 2005]. The aim of our study was to analyse the influence of the patella height on the patients’ functional outcome after surgery. The functional outcome was measured by the “Munich Knee Questionaire” (MKQ) These MKQ results of different patella heights and fracture types were compared. Conclusion Our results demonstrate that different postoperative patella heights apparently do not influence the functional outcome in the short follow-up. The low clinical and functional outcome after patella fractures is discussed in either biological aspects (pathologies of the synovia and/or Hoffa’s fat pat) or referring in to biomechanical malformations due to, e.g., increased patella height with raised patella-femoral contact pressure during extensive movements [11,12,13]. The aim of our study was to retrospectively analyze the influence of the postoperative patella height on the functional outcome following operatively treated patella fractures over a 13-year period
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