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Gap Non-union Patella Fractures: Case Report and Review of the Literature
INTRODUCTION: Gap non-union patella fractures are rare but can be particularly challenging for the orthopedic surgeon. We report a case of a 12 cm gap non-union patella fracture in a patient with osteoporosis and its surgical management, functional outcome, and implications on clinical practice. CAS...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Indian Orthopaedic Research Group
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727447/ https://www.ncbi.nlm.nih.gov/pubmed/31534939 http://dx.doi.org/10.13107/jocr.2250-0685.1376 |
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author | Al-Obaedi, Ossama RThakrar, Raj Kundra, Rik Iqbal, Mohammad J |
author_facet | Al-Obaedi, Ossama RThakrar, Raj Kundra, Rik Iqbal, Mohammad J |
author_sort | Al-Obaedi, Ossama |
collection | PubMed |
description | INTRODUCTION: Gap non-union patella fractures are rare but can be particularly challenging for the orthopedic surgeon. We report a case of a 12 cm gap non-union patella fracture in a patient with osteoporosis and its surgical management, functional outcome, and implications on clinical practice. CASE REPORT: A 73-year-old fully independent female with a background of osteoporosis was referred to our outpatient knee clinic. She reported a fall from stairs following an initial soft-tissue injury to the left knee 6 months prior. She has had progressive decline in mobility since the injury and was restricted to a wheelchair when she was seen in clinic. On examination, she had significant wasting of the quadriceps on the left side. Her range of movement was from 40° extensor lag to 90° flexion actively. Passive movements of the knee were preserved. She was unable to straight leg raise. Plain radiographs revealed a 12 cm gap non-union of her left patella. The patient was managed operatively in a two-staged approach. The first stage involved application of ring fixator device to achieve gradual skeletal traction from 5 to 12 lbs over a period of 10 days. The second stage involved conventional tension band wiring. CONCLUSION: At 1-year follow-up, the patient achieved full independent mobility. This case highlights the efficacy of a two-staged approach in the management of gap non-union patella fractures in patients with poor bone quality. |
format | Online Article Text |
id | pubmed-6727447 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Indian Orthopaedic Research Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-67274472019-09-18 Gap Non-union Patella Fractures: Case Report and Review of the Literature Al-Obaedi, Ossama RThakrar, Raj Kundra, Rik Iqbal, Mohammad J J Orthop Case Rep Case Report INTRODUCTION: Gap non-union patella fractures are rare but can be particularly challenging for the orthopedic surgeon. We report a case of a 12 cm gap non-union patella fracture in a patient with osteoporosis and its surgical management, functional outcome, and implications on clinical practice. CASE REPORT: A 73-year-old fully independent female with a background of osteoporosis was referred to our outpatient knee clinic. She reported a fall from stairs following an initial soft-tissue injury to the left knee 6 months prior. She has had progressive decline in mobility since the injury and was restricted to a wheelchair when she was seen in clinic. On examination, she had significant wasting of the quadriceps on the left side. Her range of movement was from 40° extensor lag to 90° flexion actively. Passive movements of the knee were preserved. She was unable to straight leg raise. Plain radiographs revealed a 12 cm gap non-union of her left patella. The patient was managed operatively in a two-staged approach. The first stage involved application of ring fixator device to achieve gradual skeletal traction from 5 to 12 lbs over a period of 10 days. The second stage involved conventional tension band wiring. CONCLUSION: At 1-year follow-up, the patient achieved full independent mobility. This case highlights the efficacy of a two-staged approach in the management of gap non-union patella fractures in patients with poor bone quality. Indian Orthopaedic Research Group 2019 /pmc/articles/PMC6727447/ /pubmed/31534939 http://dx.doi.org/10.13107/jocr.2250-0685.1376 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Al-Obaedi, Ossama RThakrar, Raj Kundra, Rik Iqbal, Mohammad J Gap Non-union Patella Fractures: Case Report and Review of the Literature |
title | Gap Non-union Patella Fractures: Case Report and Review of the Literature |
title_full | Gap Non-union Patella Fractures: Case Report and Review of the Literature |
title_fullStr | Gap Non-union Patella Fractures: Case Report and Review of the Literature |
title_full_unstemmed | Gap Non-union Patella Fractures: Case Report and Review of the Literature |
title_short | Gap Non-union Patella Fractures: Case Report and Review of the Literature |
title_sort | gap non-union patella fractures: case report and review of the literature |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727447/ https://www.ncbi.nlm.nih.gov/pubmed/31534939 http://dx.doi.org/10.13107/jocr.2250-0685.1376 |
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