title: Early complications in the operative treatment of patella fractures.
abstract: OBJECTIVE
  To identify and review early complications in the operative treatment of patella fractures.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Single tertiary care institution with multiple surgeons, including generalists and fellowship trained subspecialists.
  
  
  METHODS
  A consecutive series of eighty-seven patella fractures over a five year period was reviewed. Patients treated nonoperatively or with partial or total patellectomy were excluded. Minimum follow-up to fracture healing (four months) was available in fifty-one fractures.
  
  
  METHODS
  Modified tension band wire fixation was used in forty-nine fractures, whereas two fractures were treated with tension band wires threaded through cannulated screws.
  
  
  METHODS
  Early complications such as loss of reduction or fixation, infection, or soft-tissue problems were evaluated.
  
  
  RESULTS
  Displacement of > or = 2 mm before healing was noted in eleven fractures. The displacement could be attributed to technical errors in five cases, and to patient noncompliance with postoperative activity restrictions in another five cases. Two cases of superficial infection were documented. Nine patients with symptomatic hardware required hardware removal.
  
  
  CONCLUSIONS
  Twenty-two percent of fractures treated with tension band wiring and early motion displaced > or = 2 mm within the early postoperative period. Technical errors or patient noncompliance were identified as factors. The incidence of early complications in operatively treated patella fractures is higher than previously reported.
authors.affiliation: Department of Orthopaedics, Henry Ford Hospital, Detroit, MI 48202, USA.
authors.forename: S T
authors.initials: ST
authors.lastname: Smith
authors.forename: K E
authors.initials: KE
authors.lastname: Cramer
authors.forename: D E
authors.initials: DE
authors.lastname: Karges
authors.forename: J T
authors.initials: JT
authors.lastname: Watson
authors.forename: B R
authors.initials: BR
authors.lastname: Moed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires; D002648:Child; D005260:Female; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000293:injuries*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure