Open reduction internal fixation of displaced transverse patella fractures with figure-eight wiring through parallel cannulated compression screws.
OBJECTIVE
To evaluate the clinical results of transverse patella fracture fixation with a tensioned anterior figure-eight wire placed through parallel cannulated screws.


METHODS
Prospective, clinical.


METHODS
Ten patients with displaced transverse patella fractures were managed with a standardized rehabilitation protocol that employed early continuous passive knee motion.


METHODS
Time to clinical and radiographic union, Hospital for Special Surgery Knee Scores, and comparisons with literature cohort studies.


RESULTS
Clinical union occurred at an of average eight weeks and radiographic union at a mean of thirteen weeks postoperatively. Early continuous passive motion over a restricted are did not compromise the quality of fracture reduction, even though the majority of patients were elderly and had osteopenic bone. Subjective and functional results using Hospital for Special Surgery Knee Scores were comparable to previously published reports, with 70 percent achieving an excellent or good outcome.


CONCLUSIONS
The described fixation technique for transverse patella fractures had clinical results equivalent to reports of patella fractures fixed with modified tension band wiring. Advantages included a low-profile construct that caused lesser degrees of implant irritation to local soft tissue structures, was compatible with the use of early restricted motion, and afforded a method to salvage three cases in which traditional tension band wiring failed to maintain an anatomic reduction in oteoporotic bone.
Berg
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New Hampshire Bone & Joint Institute, Bedford, NH 03110, USA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001851:Bone Diseases, Metabolic / Q000150:complications; D001863:Bone Screws; D001864:Bone Wires; D015331:Cohort Studies; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive; D010024:Osteoporosis / Q000150:complications; D010329:Patella / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome