Treatment of patellar fractures with cannulated screws and a titanium cable

Abstract

Objective To evaluate clinical effects of cannulated screws and a titanium cable in the treatment of patellar fractures. Methods From February 2008 to September 2010, 27 patients with patellar fracture were treated in our department. They were 11 males and 16 females, with an average age of 44. 2 years (from 23 to 65 years) . All cases were closed fracture without other injuries. According to the Rockwood s classification, 11 cases were Type Ⅱ, 9 Type Ⅲ, 5 Type Ⅳ and 2 Type Ⅴ. After open reduction, 2 guide pins (1. 25 mm) were drilled vertically through the patella in a superior or inferior direction to let half-threaded tapping cannulated screws go 4. 0 mm along the guide pin. A 1. 3 mm titanium cable traversed the cannulated screws and formed an 8-shaped tension band structure. All patients conducted knee joint isometric contraction one to 2 days after operation, did continuous passive motion (CPM) exercise after 3 days, walked with the brace after one week, did active flexion and extension training after 2 weeks, removed the brace protection after 3 weeks and conducted weight-bearing walking after 6 weeks. Results The 27 patients were followed up for an average of 12 months (from 6 to 24 months) . All patients achieved clinical healing after 6 weeks and bony consolidation after an average of 2. 6 months (2 to 3 months). The mean range of motion of the keen was 0 to 130°. Fractures healed without such complications as loosening of cable loop,screw breakage, soft tissue infection or rejection reaction. By the Bostman' s criteria, functional recovery was excellent in 24 cases and good in 3, with an excellent to good rate of 100%. Conclusion Treatment of patellar fractures with cannulated screws and a titanium cable is characterized by simple manipulation, reliable fixation, early rehabilitation and a high healing rate. Key words: Patella; Fracture fixation, internal; Bone nails; Titanium