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Predictors for nonunion, reoperation and infection after surgical fixation of patellar fracture

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Introduction

The most common major complications following surgical fixation of patellar fractures are infection, nonunion and reoperation. In this study, we sought to define the predisposing factors to the development of these complications.

Methods

Open reduction and internal fixation surgeries for patellar fractures that were performed in a single institution between 2006 and 2011 were retrospectively reviewed. Patients' demographic data (age, gender, comorbidities), injury and fracture data (associated injuries, type of fracture, open or closed fracture), surgical data (type of surgery and interval between fracture occurrence and surgery) and major postoperative complications (infection, nonunion, symptomatic hardware and revision surgery) were collected from the medical records and verified by a telephone survey. Correlation analysis identified the major variables influencing the development of these complications.

Results

The cohort of 188 patients had an average follow-up of 908 days. Thirteen (6.9 %) patients developed infection, 3 (1.6 %) had fracture nonunion and 42 (22.3 %) required a second operation. A history of cerebrovascular accident (CVA) correlated significantly with the development of infection (OR 6.18, CI 1.1–35.6, p = 0.041) and nonunion (OR 14.9, CI 1.2–188.1; p = 0.037). A history of diabetes significantly increased the risk of a second operation (OR 8.69, CI 95 % 1.8–41.9, p = 0.007). Open fracture did not increase the risk of any of these complications.

Conclusions

A history of CVA and diabetes mellitus significantly increased the risk of complications following patellar fracture fixation. Patients with these comorbidities should be informed of their increased risk of these complications and be followed up more rigorously.

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Acknowledgments

Esther Eshkol is thanked for editorial assistance.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Orthopedic Division, Tel Aviv, Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, Tel Aviv, 6423906, Israel

    Assaf Kadar, Haggai Sherman, Eldad Katz & Ely Liviu Steinberg

  2. Epidemiology Department, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Yael Glazer

Authors
  1. Assaf Kadar
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  2. Haggai Sherman
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  3. Yael Glazer
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  4. Eldad Katz
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  5. Ely Liviu Steinberg
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Correspondence to Assaf Kadar.

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Kadar, A., Sherman, H., Glazer, Y. et al. Predictors for nonunion, reoperation and infection after surgical fixation of patellar fracture. J Orthop Sci 20, 168–173 (2015). https://doi.org/10.1007/s00776-014-0658-4

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  • DOI: https://doi.org/10.1007/s00776-014-0658-4

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