title: [Management of inferior polar comminuted fractures of patella and patellar tendon injury].
abstract: OBJECTIVE
  To investigate the treatment and effectiveness of inferior polar comminuted fractures of patella and patellar tendon injury.
  
  
  METHODS
  Between January 2003 and December 2008, 5 patients with inferior polar comminuted fractures of patella and patellar tendon injury were treated with Nitinol Patellar Concentrator and fascia lata allograft. There were 3 males and 2 females with a mean age of 33.7 years (range, 20-48 years). The interval of injury and operation was 1-5 days. Fracture degree: 3 cases had 3 fractures of patella, 2 cases had 4 fractures; patellar tendon injury degree: 3 cases had horizontal rupture of middle ligament, 1 case had oblique rupture of tibial tubercle, and 1 case had longitudinal partial rupture.
  
  
  RESULTS
  Healing of incision by first intention was achieved in all patients, and no complication of infection or deep venous thrombosis occurred. The X-ray films at 2 days after surgery showed that patella recovered to normal height, which meaned ratio of patella height to patellar tendon length recovered to 1 : 1. Five cases were followed up 18 months on average (range, 10-22 months). At 3-12 weeks after surgery, the knee function of the injury side almost reached that of the normal side in 4 patients, and the knee range of motion was about 100 degrees in 1 patient. The fracture healing time was 3-5 months. At 12-15 months after surgery, patella holder was taken out and no lost of reduction or refracture occurred. During follow-up, there was no fracture displacement, loosening and breakage of implant, or rerupture of patellar tendon. According to ZHANG Chuncai's criterion for knee joint function, the results were excellent in 3 cases, good in 1 cases, and fair in 1 case with an excellent and good rate of 80%. According to XU Shaoting's criterion for knee joint function, the results were excellent in 2 cases, good in 2 cases, and fair in 1 case with an excellent and good rate of 80%.
  
  
  CONCLUSIONS
  Nitinol Patellar Concentrator and fascia lata allograft is a new method to treat inferior polar comminuted fractures of patella and patellar tendon injury, and it can ensure the knee joint stability in early motion after surgery.
authors.affiliation: Department of Orthopaedics, Affiliated Changhai Hospital of the Second Military Medical University, Shanghai 200433, PR China.
authors.forename: Yuntong
authors.initials: Y
authors.lastname: Zhang
authors.forename: Panfeng
authors.initials: P
authors.lastname: Wang
authors.forename: Chuncai
authors.initials: C
authors.lastname: Zhang
authors.forename: Qingge
authors.initials: Q
authors.lastname: Fu
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000497:Alloys; D005260:Female; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010329:Patella / Q000293:injuries*; D017847:Patellar Ligament / Q000293:injuries*; D013708:Tendon Injuries / Q000601:surgery*; D055815:Young Adult
chemical_list: D000497:Alloys; C013616:nitinol