Arthroscopically Assisted Percutaneous Screwing of Patellar Fractures

OBJECTIVES: Restore patellar anatomy and function of extensor mechanism. Reduction of surgical time, improval of rehabilitation and reduce complications of open surgery. METHODS: 37 patients with transverse patella fracture operated from June 2004 to April 2012. Inclusion criterion: Both sexes, age 20 to 65 years. Less than 10 days since fracture. Transverse fractures. Exclusion criterion: Comminuted , longitudinal and open fractures. More than 10 days since fracture. Fractures classified with AO and Watson Jones classifications. In all cases close reduction and percutaneous osteosynthesis with conic,canulated, compressive, full threaded screws of 3,5 and/or 5 mm diameter under fluoroscopic and arthroscopic assistance, was performed. Medium follow-up was 31 months (range 24-46) Comparative clinical evaluation of both knees was done: physical exam, X-rays and functional scales ( IKDC ; Lisholm Score, Knee Society score ). RESULTS: Excellent results were achieved in 34 of 37 cases (91.9%). Three patients that had minor complications referred good and fair results: 1 case complain of occasional mild pain, another patient had 110 degrees of flexion compared to 145º on the normal knee and 1 patient had a 3mm step but remains asymptomatic. They were no infections and non needed screw removal. CONCLUSION: Percutaneous surgery under arthroscopic and fluoroscopic assistance , showed to be a simple and beneficial method for transverse patellar fractures. It takes shorter surgical and hospitalization time. Diminishes complications, morbidity, and achieves earlier range of motion.