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Outcomes after locked plating of displaced patella fractures: a prospective case series

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Abstract

Purpose

Tension band wiring remains a common treatment for patella fractures, but complication rates are high, with unsatisfactory results. The purpose of this observation study was to evaluate clinical results and complication rates of a novel patella locking plate fixation.

Methods

Twenty patients (mean age, 59.2 ± 18 years) with displaced patella fractures were prospectively enrolled. Range of motion, knee scores (Tegner, Lysholm, Kujala), complications, and revision surgeries were assessed six weeks, six months, 12 months, and 24 months after surgery. Results were compared to the situation before trauma in regards to the time of follow-up using a paired sample t test.

Results

According to the OTA classification, the fractures were classified as follows: one A1, four C1, six C2, and nine C3. Range of motion improved from 121° after six weeks to 140°, 141°, and 143° within the follow-up period. While the Tegner, Lysholm, and Kujala scores were 4.1/97/97, respectively, before trauma, they improved from 2.6/80/89 to 3.6/94/89, 3.7/95/94, and 4.1/97/97 within the follow-up period. Three patients had a complication (15%): one fracture dislocation, one reactive bursitis, and one renewed fracture. Four patients reported discomfort or anterior knee pain especially when kneeling on the implant.

Conclusions

The patella locking plate is a safe and effective treatment for patella fractures, including comminuted fractures. Function can be restored within six months after surgery, and the complication rate is low. Nonetheless, the implant can cause discomfort or anterior knee pain especially when kneeling, which can necessitate an implant removal.

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Authors and Affiliations

  1. Department for Orthopaedic Surgery, Medical School Hannover, DIAKOVERE Annastift, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany

    Alexander Ellwein & Tomas Smith

  2. Department for Orthopaedic Surgery and Traumatology, DIAKOVERE Friederikenstift, Humboldtstr. 5, 30169, Hannover, Germany

    Alexander Ellwein, Helmut Lill & Rony-Orijit DeyHazra

  3. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, building W1, 48149, Münster, Germany

    Jan Christoph Katthagen

Authors
  1. Alexander Ellwein
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  2. Helmut Lill
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  3. Rony-Orijit DeyHazra
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  4. Tomas Smith
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  5. Jan Christoph Katthagen
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Corresponding author

Correspondence to Alexander Ellwein.

Ethics declarations

The local ethics committee approved the study protocol. All work complied with the principles laid down in the Declaration of Helsinki. The study was registered at ClinicalTrial.gov (NCT02015975).

Conflict of interest

H.L. is consultant for Arthrex GmbH. JC.K. is on the speakers’ bureau of Arthrex GmbH. All other authors declare that they have no conflict of interest.

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Ellwein, A., Lill, H., DeyHazra, RO. et al. Outcomes after locked plating of displaced patella fractures: a prospective case series. International Orthopaedics (SICOT) 43, 2807–2815 (2019). https://doi.org/10.1007/s00264-019-04337-7

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  • DOI: https://doi.org/10.1007/s00264-019-04337-7

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