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Patellar nonunions: Comparison of various surgical methods of treatment.

Garg P, Sahoo S, Satyakam K, Biswas D, Garg A, Mitra S - Indian J Orthop (2012)

Bottom Line: Many of them have a functional knee joint and only those with a wide gap and failed extensor mechanism need surgery.We compared the results of the treatment in terms of Knee Society Score (KSS), Melbourne patella score, time of union, pain, range of movement, quadriceps power, and ability to do daily activities and complications encountered.Cases with patellectomy showed the next best results but they had a longer period of rehabilitation with ultimately lesser patient satisfaction.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Institute of Post Graduate Medical Education and Research, Kolkata, India.

ABSTRACT

Background: Nonunion of patella is an uncommon entity prevalent more commonly in developing countries. Many of them have a functional knee joint and only those with a wide gap and failed extensor mechanism need surgery. We report an analysis of nonunion of fracture patella treated by 3 surgical method.

Materials and methods: 35 patients of nonunion/delayed union of patella with significant gap and failure of quadriceps mechanism, underwent three different methods surgically: 1) V-Y plasty and tension band wiring (n=10); 2) patellar traction followed by tension band wiring without V-Y plasty (n=15); and 3) patellar traction followed by partial or total patellectomy (n=10). We compared the results of the treatment in terms of Knee Society Score (KSS), Melbourne patella score, time of union, pain, range of movement, quadriceps power, and ability to do daily activities and complications encountered.

Results: The 15 cases of patellar traction followed by tension band wiring showed the best results in terms of time to return to normal activities and complications encountered. Cases with patellectomy showed the next best results but they had a longer period of rehabilitation with ultimately lesser patient satisfaction. V-Y plasty gave the worst results both in complication rate and function return.

Conclusion: Preoperative patellar traction followed by tension band wiring is a good procedure giving better results than either patellectomy or V-Y plasty.

No MeSH data available.


Related in: MedlinePlus

The bar diagram shows long term results
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Figure 5: The bar diagram shows long term results

Mentions: On a subjective scale of operative difficulty, graded as 0 for fresh fractures and 3 as most difficult. V-Y plasty with TBW was graded as 3 while patellar traction followed by TBW and patellectomy were graded as 1. Average range of motion (ROM) at 3 months postoperative, average time to return to daily activities, average time of union, average increase in KSS and Melbourne patella score 6 month postoperative were recorded and displayed in Table 1 and Figures 4 and 5.


Patellar nonunions: Comparison of various surgical methods of treatment.

Garg P, Sahoo S, Satyakam K, Biswas D, Garg A, Mitra S - Indian J Orthop (2012)

The bar diagram shows long term results
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377141&req=5

Figure 5: The bar diagram shows long term results
Mentions: On a subjective scale of operative difficulty, graded as 0 for fresh fractures and 3 as most difficult. V-Y plasty with TBW was graded as 3 while patellar traction followed by TBW and patellectomy were graded as 1. Average range of motion (ROM) at 3 months postoperative, average time to return to daily activities, average time of union, average increase in KSS and Melbourne patella score 6 month postoperative were recorded and displayed in Table 1 and Figures 4 and 5.

Bottom Line: Many of them have a functional knee joint and only those with a wide gap and failed extensor mechanism need surgery.We compared the results of the treatment in terms of Knee Society Score (KSS), Melbourne patella score, time of union, pain, range of movement, quadriceps power, and ability to do daily activities and complications encountered.Cases with patellectomy showed the next best results but they had a longer period of rehabilitation with ultimately lesser patient satisfaction.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Institute of Post Graduate Medical Education and Research, Kolkata, India.

ABSTRACT

Background: Nonunion of patella is an uncommon entity prevalent more commonly in developing countries. Many of them have a functional knee joint and only those with a wide gap and failed extensor mechanism need surgery. We report an analysis of nonunion of fracture patella treated by 3 surgical method.

Materials and methods: 35 patients of nonunion/delayed union of patella with significant gap and failure of quadriceps mechanism, underwent three different methods surgically: 1) V-Y plasty and tension band wiring (n=10); 2) patellar traction followed by tension band wiring without V-Y plasty (n=15); and 3) patellar traction followed by partial or total patellectomy (n=10). We compared the results of the treatment in terms of Knee Society Score (KSS), Melbourne patella score, time of union, pain, range of movement, quadriceps power, and ability to do daily activities and complications encountered.

Results: The 15 cases of patellar traction followed by tension band wiring showed the best results in terms of time to return to normal activities and complications encountered. Cases with patellectomy showed the next best results but they had a longer period of rehabilitation with ultimately lesser patient satisfaction. V-Y plasty gave the worst results both in complication rate and function return.

Conclusion: Preoperative patellar traction followed by tension band wiring is a good procedure giving better results than either patellectomy or V-Y plasty.

No MeSH data available.


Related in: MedlinePlus