Management of comminuted patellar fracture fixation using modified cerclage wiring
Abstract Background Although there are several different kinds of fixation techniques for displaced comminuted patellar fracture, the treatment remains a challenge for orthopaedic surgeons. The purpose of this study is to evaluate the effectiveness and safety of a fixation technique for comminuted p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-019-1385-5 |
| _version_ | 1811262588084813824 |
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| author | Yangyang Sun Kuisheng Sheng Qinghu Li Dawei Wang Dongsheng Zhou |
| author_facet | Yangyang Sun Kuisheng Sheng Qinghu Li Dawei Wang Dongsheng Zhou |
| author_sort | Yangyang Sun |
| collection | DOAJ |
| description | Abstract Background Although there are several different kinds of fixation techniques for displaced comminuted patellar fracture, the treatment remains a challenge for orthopaedic surgeons. The purpose of this study is to evaluate the effectiveness and safety of a fixation technique for comminuted patellar fracture fixation using modified cerclage wiring. Methods From February 2016 to April 2018, 38 cases of simple unilateral closed comminuted patellar fracture were treated by modified cerclage wiring. Among these cases, 16 patients were males and 22 were females, aged 23–68 years (average 40.4 ± 9.1 years). Comminuted patellar fractures were classified according to the AO/OTA classification: 10 cases were type 34-C2 (three fragments), 28 cases were type 34-C3 (more than three fragments). Postoperative complications including loosening of internal fixation, fragment re-displacement, nonunion, infection, breakage of internal fixation and traumatic osteoarthritis were assessed. The clinical results after operation were evaluated by the clinical grading scales of Böstman including range of movement, pain, work, atrophy, assistance in walking, effusion, giving way, and stair-climbing during follow-up. Results A total of 38 patients were followed up for 6–36 months (mean time 16.1 ± 5.8 months). The bone union radiographically occurred at approximately 2.5–3.5 months (mean time 2.92 ± 0.25 months). No postoperative complications, such as infection, dislocation, breakage of the implants, painful hardware, and post-traumatic osteoarthritis, were observed. According to the clinical grading scales of Böstman, satisfactory results were obtained, and the mean score at the final follow-up was 28.7 (range 20–30) points. Thirty-two patients (84.2%) with excellent results had a mean score of 29.5 ± 0.7 (range 28–30) points, and six patients (15.8%) with good results had a mean score of 24.5 ± 2.2 (range 20–27) points. The patients with excellent and good scores had active flexion of 130° (110–140). Conclusions Modified cerclage wiring can effectively treat comminuted patellar fracture and offers a new strategy resulting in satisfactory results without obvious complications. |
| first_indexed | 2024-04-12T19:28:12Z |
| format | Article |
| id | doaj.art-333461c806a94879ad6115a844253b64 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-12T19:28:12Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-333461c806a94879ad6115a844253b642022-12-22T03:19:25ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-10-011411810.1186/s13018-019-1385-5Management of comminuted patellar fracture fixation using modified cerclage wiringYangyang Sun0Kuisheng Sheng1Qinghu Li2Dawei Wang3Dongsheng Zhou4Department of Orthopaedic Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Orthopaedic Surgery, Rizhao Traditional Chinese Medical HospitalDepartment of Orthopaedic Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Orthopaedic Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Orthopaedic Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityAbstract Background Although there are several different kinds of fixation techniques for displaced comminuted patellar fracture, the treatment remains a challenge for orthopaedic surgeons. The purpose of this study is to evaluate the effectiveness and safety of a fixation technique for comminuted patellar fracture fixation using modified cerclage wiring. Methods From February 2016 to April 2018, 38 cases of simple unilateral closed comminuted patellar fracture were treated by modified cerclage wiring. Among these cases, 16 patients were males and 22 were females, aged 23–68 years (average 40.4 ± 9.1 years). Comminuted patellar fractures were classified according to the AO/OTA classification: 10 cases were type 34-C2 (three fragments), 28 cases were type 34-C3 (more than three fragments). Postoperative complications including loosening of internal fixation, fragment re-displacement, nonunion, infection, breakage of internal fixation and traumatic osteoarthritis were assessed. The clinical results after operation were evaluated by the clinical grading scales of Böstman including range of movement, pain, work, atrophy, assistance in walking, effusion, giving way, and stair-climbing during follow-up. Results A total of 38 patients were followed up for 6–36 months (mean time 16.1 ± 5.8 months). The bone union radiographically occurred at approximately 2.5–3.5 months (mean time 2.92 ± 0.25 months). No postoperative complications, such as infection, dislocation, breakage of the implants, painful hardware, and post-traumatic osteoarthritis, were observed. According to the clinical grading scales of Böstman, satisfactory results were obtained, and the mean score at the final follow-up was 28.7 (range 20–30) points. Thirty-two patients (84.2%) with excellent results had a mean score of 29.5 ± 0.7 (range 28–30) points, and six patients (15.8%) with good results had a mean score of 24.5 ± 2.2 (range 20–27) points. The patients with excellent and good scores had active flexion of 130° (110–140). Conclusions Modified cerclage wiring can effectively treat comminuted patellar fracture and offers a new strategy resulting in satisfactory results without obvious complications.http://link.springer.com/article/10.1186/s13018-019-1385-5Patellar fractureComminuted fractureCerclage wiring |
| spellingShingle | Yangyang Sun Kuisheng Sheng Qinghu Li Dawei Wang Dongsheng Zhou Management of comminuted patellar fracture fixation using modified cerclage wiring Journal of Orthopaedic Surgery and Research Patellar fracture Comminuted fracture Cerclage wiring |
| title | Management of comminuted patellar fracture fixation using modified cerclage wiring |
| title_full | Management of comminuted patellar fracture fixation using modified cerclage wiring |
| title_fullStr | Management of comminuted patellar fracture fixation using modified cerclage wiring |
| title_full_unstemmed | Management of comminuted patellar fracture fixation using modified cerclage wiring |
| title_short | Management of comminuted patellar fracture fixation using modified cerclage wiring |
| title_sort | management of comminuted patellar fracture fixation using modified cerclage wiring |
| topic | Patellar fracture Comminuted fracture Cerclage wiring |
| url | http://link.springer.com/article/10.1186/s13018-019-1385-5 |
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