A Double Cerclage and Tension band Wiring Technique Fixation for Comminuted Patellar Fractures
Background and objectives: When the patella is fractured it should be repaired and patellectomy should be avoided as much as possible even in comminuted fractures. In comminuted patellar fractures, a combination of cerclage wiring and tension band fixation is confirmed to provide good mechanical stability.
Patients and methods: Forty- six patients underwent surgical stabilization for comminuted patellar fracture between year 1996 to 2016 .
All fractures were classified as 34-C3 according to the Orthopaedic Trauma Association classification. All the patients were underwent open reduction- internal fixation with combined Cerclage and tension band wiring technique.
Results: Fracture healing was occurred within an average of 3- 5 months, while in bilateral cases it was 4 - 8 months. Full range of knee movements was seen in 42 ( 91.3 % ) cases and knee flexion more than 120º was seen in 4 ( 8.7 % ) cases. Quadriceps power was normal in 44 ( 95.6 % ) cases but 2 cases had quadriceps power of grade-IV. No extensor lag and no quadriceps atrophy was seen in any cases . Forty four ( 95.6 % ) patients could squat fully and two ( 4.3 % ) patients could squat up to half of the normal level. All patients were able to climb up and down stairs without any problem.
Conclusion: This study had concluded that combined Cerclage and tension band wiring technique was a successful surgical treatment for comminuted fractures of the Patella.
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