Abstract
BackgroundPatella fractures requiring surgery are traditionally treated using metallic implants, which are associated with high re-operation rates, mainly due to implant prominence. To overcome the problem of prominent metallic implants, we present a technique based purely on braided sutures.MethodsThis technique is described in a step-wise, standardised way based on our findings on six patients treated at our institution.ResultsThis technique can be adapted to all types of patella fractures. The described suture configuration allows maintenance of inter-fragmentary reduction until bony union without symptoms from the suture material.ConclusionsWe believe that this technique is a safe and promising alternative to traditional metallic fixation methods.
Highlights
BackgroundFractures of the patella account for about 1% of all fractures in adults [1]. Patella fracture is commonly caused by either direct trauma (e.g. simple fall onto the knee or motor vehicle injuries) or indirectly following a forceful contraction of the quadriceps with the knee in a flexed position [2]
Patella fractures requiring surgery are traditionally treated using metallic implants, which are associated with high re-operation rates, mainly due to implant prominence
To overcome the problem of prominent implants without compromising stable fixation, we describe a standardised method for the fixation of simple transverse and comminuted patella fractures using nonabsorbable, high-strength braided sutures applied only in soft tissue
Summary
Fractures of the patella account for about 1% of all fractures in adults [1]. Patella fracture is commonly caused by either direct trauma (e.g. simple fall onto the knee or motor vehicle injuries) or indirectly following a forceful contraction of the quadriceps with the knee in a flexed position [2]. The indications for surgical fixation of a patella fracture are an absent extensor mechanism (patient not able to lift leg straight), articular displacement >2 mm, or interfragmentary displacement >3 mm [7, 8]. Regardless of surgical technique, the goals of surgical treatment are the anatomical reduction of the articular surface, stable fixation able to withstand the deforming forces acting on the patella during the healing process and the preservation of a functional extensor apparatus to start early range of motion [1, 2, 9, 10]. To overcome the problem of prominent implants without compromising stable fixation, we describe a standardised method for the fixation of simple transverse and comminuted patella fractures using nonabsorbable, high-strength braided sutures applied only in soft tissue
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