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To plate, or not to plate? A systematic review of functional outcomes and complications of plate fixation in patellar fractures

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Abstract

Purpose

Poor outcomes and high complication and reoperation rates have been reported with tension-band wiring (TBW) in the management of patellar fractures and particularly the comminuted ones. The purpose of this study was to investigate the functional outcomes and complication rates of patellar fractures managed with open reduction and internal fixation (ORIF) with a plate.

Methods

MEDLINE, EMCare, CINAHL, AMED and HMIC were searched, and the PRISMA guidelines were followed. Two independent reviewers extracted the data from the included studies and assessed them for the risk of bias.

Results

Plating of patellar fractures is associated with satisfactory range of movement (ROM) and postoperative function and low pain levels. We found a 10.44% complication rate and a low reoperation rate. Reoperations were mainly performed for metalwork removal.

Conclusion

ORIF with plating of patellar fractures is a safe alternative in the management of patellar fractures and may be associated with a lower complication and reoperation rate compared to TBW. Future randomized prospective studies are needed to validated the results of the present systematic review.

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Funding

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Authors and Affiliations

  1. Department of Trauma and Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

    Stavros Tsotsolis

  2. Department of Trauma and Orthopaedics, Barts Health NHS Trust, Royal London Hospital, Whitechapel Road, London, E1 1FR, UK

    Joon Ha, Maximilian Dewhurst, Thomas Walker, Amit Patel & Freideriki Poutoglidou

  3. Department of Trauma and Orthopaedics, York and Scarborough NHS Trust, York, UK

    Andre Rui Coelho Fernandes

  4. Faculty of Medicine, Imperial College London, London, UK

    Jae Yong Park & Se ri Park

  5. University Hospitals of Derby and Burton NHS Trust, Royal Derby Hospital, Derby, UK

    Kevin Ilo

  6. Kings College Hospital NHS Foundation Trust, London, UK

    Thomas Hester

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  1. Stavros Tsotsolis
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Correspondence to Freideriki Poutoglidou.

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Tsotsolis, S., Ha, J., Fernandes, A.R.C. et al. To plate, or not to plate? A systematic review of functional outcomes and complications of plate fixation in patellar fractures. Eur J Orthop Surg Traumatol 33, 3287–3297 (2023). https://doi.org/10.1007/s00590-023-03597-9

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