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Clinical Cases in mineral and bone metabolism

Displaced patella fractures: percutaneous cerclage wiring and second arthroscopic look

Mini-review, 48 - 52
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Abstract
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Introduction. The patella has an important role in the knee joint extension mechanism and that it’s why it is of the most importance to restore the continuity of the articular surface during surgery. In patella fractures, in addition to the bone’s damage, there is an injury of soft tissues and surrounding structures that make the knee extension possible. For the purpose of their repairing we use percutaneous cerclage wiring. After bone consolidation, we perform an arthroscopic revision in order to check it as prove of the effectiveness of the technique and the post-traumatic chondral lesions.
Methods. In this study we treated 20 patients with patella fractures. All cases were closed fractures, and the AO classification was 34-C1 in 6 cases, 34-C2 in 5, 34-C3 in 9. The mean follow-up was 23 months (18-31). In all cases we performed a radiographic control at the end of the synthesis and in each following clinic control. We also evaluated them with an arthroscopic control.
Results. No limitation of extension was noted in any patient and the mean flexion was 143° (120-160). In all 20 cases we had evidence of radiographic consolidation at 6 months. We didn’t have any non-union cases or failures of the fixation devices.
Conclusions. To perform a percutaneous patella fixation has the same results as the tension band technique with less damage to the soft tissues. Level of evidence. Prospective case series. Therapeutic, Level IV.

Vol. XVI (No. 1) 2019 January - April

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