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Plate osteosynthesis after patellar fracture: 1-year results of a prospective study
AIMS AND OBJECTIVES: Tension band wiring after patellar fractures is associated to a high number of implant related complications (22-53%). Revision surgery is necessary in 10-55% of the patients with mostly unsatisfactory results. The patella plate is an alternative treatment with the advantages of...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415035/ http://dx.doi.org/10.1177/2325967117S00138 |
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author | Ellwein, Alexander Katthagen, Jan Jensen, Gunnar Lill, Helmut Raschke, Michael |
author_facet | Ellwein, Alexander Katthagen, Jan Jensen, Gunnar Lill, Helmut Raschke, Michael |
author_sort | Ellwein, Alexander |
collection | PubMed |
description | AIMS AND OBJECTIVES: Tension band wiring after patellar fractures is associated to a high number of implant related complications (22-53%). Revision surgery is necessary in 10-55% of the patients with mostly unsatisfactory results. The patella plate is an alternative treatment with the advantages of a locked plating implant. Biomechanical studies have shown a significant higher stability compared to tension band wiring. Therefore an immediate full weight bearing after surgery is allowed with the prophylaxis of knee-stiffness. The purpose of this study was to evaluate the first time clinical prospective results and complications of this new implant. MATERIALS AND METHODS: Between April 2013 and May 2015 all patients that were treated with locked plating for patella fractures were included in this prospective study. Patients were examined after 6 weeks, 6 and 12 months. Information about patient satisfaction, pain situation and the functional result were collected. Additionally subjective scores (Tegner activity score, Lysholm-score, Kujala-score) were determined and compared to their value before trauma. Complications and revision surgeries were recorded and analysed. RESULTS: 17 patients, 6 women and 11 men, with a mean age of 58 (19-87) years were included in this study. The range of motion of the injured knee was 120° after 6 weeks and improved to 138° after 6 months, corresponding to 84% and 97% of the range of motion of the healthy opposite knee. The Tegner activity scale increased from 2,5 to 3,5 (initial value: 4), the Lysholm score from 78 to 92 points (initial value: 97) and the Kujala score from 72 to 88 points (initial value: 96). Two complications occurred: one patient had a reactive bursitis praepatellaris and one patient sustained a loss of reduction. Another two patients had their implants removed. Patient satisfaction reached 94% after one year. CONCLUSION: Locked plating of patella fractures is a reliable alternative treatment with good functional outcomes, low complication rates and high patient satisfaction. Already 6 months after surgery the functional results and subjective scores reached results as before trauma. Furthermore the aftercare with immediate full-weight bearing and motion exercise improves quality of life through an early return to daily life. |
format | Online Article Text |
id | pubmed-5415035 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-54150352017-05-15 Plate osteosynthesis after patellar fracture: 1-year results of a prospective study Ellwein, Alexander Katthagen, Jan Jensen, Gunnar Lill, Helmut Raschke, Michael Orthop J Sports Med Article AIMS AND OBJECTIVES: Tension band wiring after patellar fractures is associated to a high number of implant related complications (22-53%). Revision surgery is necessary in 10-55% of the patients with mostly unsatisfactory results. The patella plate is an alternative treatment with the advantages of a locked plating implant. Biomechanical studies have shown a significant higher stability compared to tension band wiring. Therefore an immediate full weight bearing after surgery is allowed with the prophylaxis of knee-stiffness. The purpose of this study was to evaluate the first time clinical prospective results and complications of this new implant. MATERIALS AND METHODS: Between April 2013 and May 2015 all patients that were treated with locked plating for patella fractures were included in this prospective study. Patients were examined after 6 weeks, 6 and 12 months. Information about patient satisfaction, pain situation and the functional result were collected. Additionally subjective scores (Tegner activity score, Lysholm-score, Kujala-score) were determined and compared to their value before trauma. Complications and revision surgeries were recorded and analysed. RESULTS: 17 patients, 6 women and 11 men, with a mean age of 58 (19-87) years were included in this study. The range of motion of the injured knee was 120° after 6 weeks and improved to 138° after 6 months, corresponding to 84% and 97% of the range of motion of the healthy opposite knee. The Tegner activity scale increased from 2,5 to 3,5 (initial value: 4), the Lysholm score from 78 to 92 points (initial value: 97) and the Kujala score from 72 to 88 points (initial value: 96). Two complications occurred: one patient had a reactive bursitis praepatellaris and one patient sustained a loss of reduction. Another two patients had their implants removed. Patient satisfaction reached 94% after one year. CONCLUSION: Locked plating of patella fractures is a reliable alternative treatment with good functional outcomes, low complication rates and high patient satisfaction. Already 6 months after surgery the functional results and subjective scores reached results as before trauma. Furthermore the aftercare with immediate full-weight bearing and motion exercise improves quality of life through an early return to daily life. SAGE Publications 2017-05-01 /pmc/articles/PMC5415035/ http://dx.doi.org/10.1177/2325967117S00138 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. |
spellingShingle | Article Ellwein, Alexander Katthagen, Jan Jensen, Gunnar Lill, Helmut Raschke, Michael Plate osteosynthesis after patellar fracture: 1-year results of a prospective study |
title | Plate osteosynthesis after patellar fracture: 1-year results of a prospective study |
title_full | Plate osteosynthesis after patellar fracture: 1-year results of a prospective study |
title_fullStr | Plate osteosynthesis after patellar fracture: 1-year results of a prospective study |
title_full_unstemmed | Plate osteosynthesis after patellar fracture: 1-year results of a prospective study |
title_short | Plate osteosynthesis after patellar fracture: 1-year results of a prospective study |
title_sort | plate osteosynthesis after patellar fracture: 1-year results of a prospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415035/ http://dx.doi.org/10.1177/2325967117S00138 |
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