Intraoperative mobilisation of knee and its effect on the final functional outcome in patella fractures: a clinical study

Abstract

<p class="abstract"><strong>Background:</strong> Treatment of patellar fractures depends on its type, integrity of extensor mechanism and fragments size. Operative measures are tension band wiring and partial or total patellectomy. Early weight bearing and then gradual mobilization and finally quadriceps strengthening remains the crux of physiotherapy. Aim of this study was to see for the effect of intraoperative mobilisation of knee on functional outcome of tension band wiring in patella fractures.</p><p class="abstract"><strong>Methods:</strong> 30 patients were included in this study from January 2016 to February 2018. Tension band wiring was performed in all the patients. Intraoperative mobilisation of knee as allowed was done when patient was under effect of anesthesia. Final functional outcome was assessed as per the modified knee-rating scale of the Hospital for Special Surgery and also range of motion noted. Patients were evaluated at 1 month, 2 month, 6 month and 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Patients aged from 25-65 years with mean age of 40 years. 26 patients were male and 4 female. In 20 cases, Right knee was involved. All had trauma due to road traffic accident. Mean operation time was 1 hour. At the end of 1 year follow up only 2 patients had range of motion <90, 4 patients had range of motion 90-120 degrees and 24 patients had range of motion >120 degrees. After 1 year, functional outcome was, excellent in 24, good in 4, fair in 1 and poor in 1.</p><p class="abstract"><strong>Conclusions:</strong> Intraoperative mobilisation of knee after a stable fixation with tension band wiring of patella can prove to a very effective method for increasing postoperative range of motion and improving functional outcome.</p>