title: Treating patella fractures with a fixed-angle patella plate-A prospective observational study.
abstract: BACKGROUND
  Anterior tension wiring using Kirschner wires (K-wires) is still considered the standard treatment for patella fractures, despite its high complication rate. The objective of this prospective clinical study was to evaluate intra- and perioperative complications as well as the clinical outcome of patients with patella fracture treated with a new developed bilateral, polyaxial, fixed-angle 2.7mm patella plate.
  
  
  METHODS
  Between 2011 and 2014 all patients with a patella fracture were included in this prospective study and treated with a fixed-angle patella plate. Avulsion fractures of the inferior or superior pole of the patella were excluded. All fractures were classified according to the AO/OTA fracture classification. During a twelve-month follow up period all intra- and postoperative complications were recorded as well as the time until fracture healing. One year postoperatively the Lysholm Score, the pre- and postoperative Tegner Score, the Hospital for Special Surgery Knee Score (HSS), the Turba Score, the Oxford Knee Score, the Knee injury and Osteoarthritis Outcome Score (KOOS), the Bostman Score and the Iowa Knee Score were surveyed. Altogether, 20 patella fractures in 19 patients were included in this prospective study. The most frequent type of fracture, n=10, was a simple transverse patella fracture (C1), followed by 7 comminuted patella fractures (C3) and 3 T-shaped patella fractures (C2).
  
  
  RESULTS
  During the 12-month follow up period two patients treated with the patella plate had a complication. In one patient a superficial wound infection occurred, which was treated successfully with hardware removal and in one patient a fracture dislocation due to an implant failure occurred. X-rays demonstrated complete bony healing in all fractures on average 3.2 months postoperatively. All knee scores showed good to excellent clinical results one year postoperatively.
  
  
  CONCLUSIONS
  The results of this first clinical study indicate that the fixed-angle patella plate is an effective and safe treatment option for patella fractures with a short operative learning curve. The treatment of communited patella fractures (C3) with a fixed-angle patella plate should be well-considered to avoid distending the indication and biomechanical properties.
authors.affiliation: Klinikum Darmstadt, Department of Orthopedics, Trauma and Hand Surgery, Grafenstr. 9, D-64283 Darmstadt, Germany. Electronic address: post@michaelwild.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Wild
authors.affiliation: Klinikum Darmstadt, Department of Orthopedics, Trauma and Hand Surgery, Grafenstr. 9, D-64283 Darmstadt, Germany. Electronic address: kai_fischer83@yahoo.de.
authors.forename: Kai
authors.initials: K
authors.lastname: Fischer
authors.affiliation: Klinikum Darmstadt, Department of Orthopedics, Trauma and Hand Surgery, Grafenstr. 9, D-64283 Darmstadt, Germany. Electronic address: florian.hilsenbeck@mail.klinikum-darmstadt.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Hilsenbeck
authors.affiliation: Vivantes Klinikum Am Urban, Department of Trauma, Orthopedic and Hand Surgery, Dieffenbachstr. 1, D-10967 Berlin, Germany. Electronic address: mohssen.hakimi@vivantes.de.
authors.forename: Mohssen
authors.initials: M
authors.lastname: Hakimi
authors.affiliation: University of Aachen, Department of Orthopedic Surgery, Pauwelsstraße 30, D-52074 Aachen, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Betsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001864:Bone Wires; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Fixed-angle patella plate; Outcome; Patella fracture; Prospective observational study; Results