A Novel Technique Of Using A Miniature Plate In Combination With Tension Band Wiring To Treat Comminuted Patellar Fractures

Objective:To assess the effectiveness of a novel technique in which a miniature plate is used in combination with tension band wiring to treat comminuted patellar fractures.Methods Between March 2013 and May 2015,16 patients with closed,displaced,comminuted fractures of the patella were included in the current study.All the 16 cases of fresh comminuted patellar fracture,12 cases were male,4 cases were female,and the age was 29~90 years old.The cause of injury: fall and kneel in 10 cases.6 cases were injured by car accident.All subjects underwent fixation using a combination of a miniature plate with a tension band wire.On the first day after operation,the patients were allowed to bear no load on the sickbed in the first day of the operation,and passive or passive flexion and extension exercises were carried out passively.After 1 weeks,CPM was used for passive functional exercise.After 2 weeks,it reached 90 o flexion and partial weight walking was allowed.The patients were followed up for 12-24 months(1、3、6、12、24).The patients’ fracture healing,complications and range of motion were measured.Knee function and patient status were evaluated at 12 months using the B?stman knee score and Lysholm knee scale.Results:The average follow-up period was 15.6 months(range,12-20 months).At the 12-month follow-up,bone healing was satisfactory in all patients.The average postoperative Lysholm score was 91.6 ± 1.4(range,84-97).The average postoperative Bostman scale score was 26.4 ± 0.5(range,22-30),thereby indicating excellent results in 4 patients and good results in 12.No patients required reoperation.Conclusion:The results demonstrate that this new technique is an effective and safe treatment option for comminuted patella fractures,as it is associated with good clinical outcomes.