Separate Vertical Wirings for the Extra-articular Fractures of the Distal Pole of the Patella
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To evaluate the usefulness of separate vertical wirings for extra-articular fracture of distal pole of patella. Materials and Methods: We have analyzed the clinical results of 18 cases that underwent separate vertical wirings for extra-articular fracture of distal pole of the patella from March 2005 to March 2010, by using the range of motion and Bostman score. Occurrence of complication was also evaluated. Additionally, by taking simple radiographs, the correlation between the postoperative degree of anterior transposition of bone fragment and the time of bone fusion, preoperative length of bone fragment, and occurrence of comminuted fracture were investigated. Results: It took an average of 13.8 weeks for radiological bone union aft er separate vertical wiring fi xation. Flexion contracture was an average of 0.8degrees and further fl exion was an average of 127.6o, and Bostman score was an average of 27.5 points (excellent in 12 cases, and good in 6 cases). On the fi rst postoperative year, average fl exion contracture was 0.6 degrees and further fl exion was an average of 136.3o, which exhibited increased joint motion and recovery to normal range of motion, and Bostman score was an average of 28.7 points (excellent in 16 cases, and good in 2 cases). Th ere was no statistically signifi cant diff erence between the preoperative bone fragment length and presence of comminution, and degree of anterior transposition of bone fragment aft er fracture union on simple radiograph (p=0.175, p=0.146). Conclusions: We were able to obtain satisfactory clinical results, while preserving the bone fragment by separate vertical wiring fi xation for extraarticular fracture of distal pole of patella. Moreover, the method is easy to perform, which is also considered as a useful surgical method for extraarticular fracture of distal pole of patella.
Abstract
Purpose: To evaluate the usefulness of separate vertical wirings for extra-articular fracture of distal pole of patella. Materials and Methods: We have analyzed the clinical results of 18 cases that underwent separate vertical wirings for extra-articular fracture of distal pole of the patella from March 2005 to March 2010, by using the range of motion and Bostman score. Occurrence of complication was also evaluated. Additionally, by taking simple radiographs, the correlation between the postoperative degree of anterior transposition of bone fragment and the time of bone fusion, preoperative length of bone fragment, and occurrence of comminuted fracture were investigated. Results: It took an average of 13.8 weeks for radiological bone union aft er separate vertical wiring fi xation. Flexion contracture was an average of 0.8degrees and further fl exion was an average of 127.6o, and Bostman score was an average of 27.5 points (excellent in 12 cases, and good in 6 cases). On the fi rst postoperative year, average fl exion contracture was 0.6 degrees and further fl exion was an average of 136.3o, which exhibited increased joint motion and recovery to normal range of motion, and Bostman score was an average of 28.7 points (excellent in 16 cases, and good in 2 cases). Th ere was no statistically signifi cant diff erence between the preoperative bone fragment length and presence of comminution, and degree of anterior transposition of bone fragment aft er fracture union on simple radiograph (p=0.175, p=0.146). Conclusions: We were able to obtain satisfactory clinical results, while preserving the bone fragment by separate vertical wiring fi xation for extraarticular fracture of distal pole of patella. Moreover, the method is easy to perform, which is also considered as a useful surgical method for extraarticular fracture of distal pole of patella.
참고문헌 (21)
- Benjamin J, "Biomechanical evaluation of various forms of fi xation of transverse patellar fractures", J Orthop Trauma, 1, pp.219~222 (1987)
- Berg EE, "Open reduction internal fi xation of displaced transverse patella fractures with figure-eight wiring through parallel cannulated compression screws", J Orthop Trauma, 11, pp.573~576 (1997)
- Bostrom A, "Fracture of the patella. A study of 422 patellar fractures", Acta Orthop Scand Suppl, 143, pp.1~80 (1972)
- Hung LK, "Fractured patella: operative treatment using the tension band principle", Injury, 16, pp.343~347 (1985)
- Johnson EE, "Fractures of the patella, in Fractures in adults. Vol. 2. 4th ed", pp.1956~1972 (1996), Lippincott Williams & Wilkins
- Kim ID, "A clinical study of the patellar fracture", J Korean Knee Soc, 3, pp.157~163 (1991)
- Levack B, "Results of surgical treatment of patellar fractures", J Bone Joint Surg Br, 67, pp.416~419 (1985)
- Lotke PA, "Transverse fractures of the patella", Clin Orthop Relat Res, (158), pp.180~184 (1981)
- Nha KW, "Cannulated scredw fi xation with fi gure-eight wiring of displaced transverse patella fractures", J Korean Orthop Assoc, 36, pp.351~354 (2001)
- Weber MJ, "Effi cacy of various forms of fi xation of transverse fractures of the patella", J Bone Joint Surg Am, 62, pp.215~220 (1980)
- Wilkinson J, "Fracture of the patella treated by total excision. A long-term follow-up", J Bone Joint Surg Br, 59, pp.352~354 (1977)
- Yang KH, "Separate vertical wiring for the fi xation of comminuted fractures of the inferior pole of the patella", J Bone Joint Surg Br, 85, pp.1155~1160 (2003)
- Carpenter JE, "Fractures of the patella", J Bone Joint Surg Am, 75, pp.1550~1561 (1993)
- Nerlich M, "Patella, in AO principals of fracture management. 1st ed", pp.483~497 (2000), Thieme
- Whittle AP, "Fractures of lower extremity, in Campbell’s operative orthopaedics. Vol. 3. 9th ed", pp.2042~2179 (1998), Mosby
- Labitzke R, "From “bone suture” to modern osteosynthesis--a chronology", Chirurg, 66, pp.452~458 (1995)
- Bostman O, "Comminuted displaced fractures of the patella", Injury, 13, pp.196~202 (1981)
- Matejcic A, "Multifragment fracture of the patellar apex: basket plate osteosynthesis compared with partial patellectomy", Arch Orthop Trauma Surg, 128, pp.403~408 (2008)
- Hughes SC, "A new and eff ective tension-band braided polyester suture technique for transverse patellar fracture fi xation", Injury, 38, pp.212~222 (2007)
- Smith ST, "Early complications in the operative treatment of patella fractures", J Orthop Trauma, 11, pp.183~187 (1997)
- Hung LK, "Partial patellectomy for patellar fracture: tension band wiring and early mobilization", J Orthop Trauma, 7, pp.252~260 (1993)