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patella fracture

S Pesch, K Kirchhoff, P Biberthaler, C Kirchhoff
Patellar fractures are a relatively rare entity with an prevalence of 1%. Preoperative computed tomography has gained a significant role as a diagnostic tool for patellar fractures in recent years. It enables an exact assessment of the fracture and helps in the decision making for the correct treatment procedure. Therapeutically, the armamentarium was supplemented by angle stable plate fixation, which potentially enables a better reconstruction of the patella than the conventional tension band fixation...
February 19, 2019: Der Unfallchirurg
E C Müller, K-H Frosch
With 1% of all skeletal fractures patellar fractures are rare. The majority of cases are caused by a direct trauma to the flexed knee. The diagnosis is made via the injury mechanism as well as the physical and radiological findings. In conventional x‑ray imaging the extent of injury often is underrated, which mostly leads to the necessity of a computed tomography (CT) scan. The aim of the treatment is the reconstruction of the extensor mechanism and the anatomical reconstruction of the articular surface...
February 11, 2019: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Jill M Martin, Dylan T Applin, Linda M McGrady, Mei Wang, Gregory J Schmeling
OBJECTIVE: This study aimed to investigate the stability and strength of tension band wire fixation using headless compression screws versus headed screws for transverse patella fractures. METHODS: Six matched pairs of fresh-frozen cadaveric knees with transverse osteotomies created at the midpoint of the patella were surgically fixed, with one knee randomly receiving fixation with headless screws (Acumed Acutrak 4/5), and the other with headed screws (Synthes 4...
January 29, 2019: Journal of Orthopaedic Trauma
Matz, Brent A. Lanting, James L. Howard
Total knee arthroplasty (TKA) is one of the most successful procedures in orthopedic surgery. Nevertheless, postoperative patellofemoral complications remain a challenging problem, affecting a substantial proportion of patients. Complications involving the patellofemoral joint (PFJ) can occur in both resurfaced and nonresurfaced patellae. Types of PFJ complications include anterior knee pain, maltracking, fracture, avascular necrosis and patellar clunk. The causes of patellofemoral complications can be categorized into patient-, surgeon- and implant-related factors...
February 1, 2019: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Steven Baker, Jacob Seales, Scotty Newcomer, Jeremy Bruce
Introduction: The overuse and repetitive loading of a bone cause a stress fracture, commonly occurring in the weight-bearing structures of the lower extremities of athletes, but rarely the patella. Patella stress fractures are an extremely rare occurrence. Müller first described a patella stress fracture in 1943; however, we could find <15 reported cases in literature since that time. Thus, some uncertainty exists as to the proper treatment of this very rare condition. Case Report: A female collegiate gymnast presented with 2-months of anterior knee pain, and initial radiographs revealed a non-displaced patella stress fracture...
July 2018: Journal of Orthopaedic Case Reports
V Schütte, A Schmidt-Hebbel, A B Imhoff, A Achtnich
OBJECTIVE: To report a surgical technique for the treatment of patellar tendon ruptures augmented with an internal brace suture tape. INDICATIONS: Acute patellar tendon ruptures, fractures of the distal patellar pole, chronic insufficiency of the patellar tendon or revision surgery for failed repairs. CONTRAINDICATIONS: Severe damage to the surrounding soft tissue. Local infection. Life-threatening conditions. SURGICAL TECHNIQUE: Direct longitudinal anterior approach to the patellar tendon...
January 25, 2019: Operative Orthopädie und Traumatologie
Ming Ling, Shi Zhan, Dajun Jiang, Hai Hu, Changqing Zhang
BACKGROUND: The position of Kirschner wires (K-wires) has an influence on the outcome of modified tension-band wiring (MTBW) in fixing patella fractures. However, the instruction for K-wires positioning is not clear enough. This study tried to clarify the effect of K-wires positioning and provide evidence for a more definite instruction. METHODS: The sagittal position (SP) suitable for placing K-wires was evenly divided into SP 1-5 from anterior to posterior, and the finite element models of midpatella transverse fractures fixed by the figure-of-eight or figure-of-zero MTBW were built up at each SP...
January 11, 2019: Journal of Orthopaedic Surgery and Research
Naoya Toriu, Toshiharu Ueno, Hiroki Mizuno, Akinari Sekine, Noriko Hayami, Rikako Hiramatsu, Keiichi Sumida, Masayuki Yamanouchi, Eiko Hasegawa, Tatsuya Suwabe, Junichi Hoshino, Naoki Sawa, Kenmei Takaichi, Takeshi Fujii, Tomoka Hasegawa, Norio Amizuka, Motoko Yanagita, Yoshifumi Ubara
We report a 48-year-old Japanese man with a brown tumor of the right distal tibia. At the age of 25 years, hemodialysis was initiated due to nail-patella syndrome. Severe secondary hyperparathyroidism and osteoporosis progressed over time, so parathyroidectomy was performed at age 45. Spontaneous fracture of the right distal tibia occurred suddenly at age 48. Imaging studies revealed a bone tumor-like lesion and surgery was performed. The resected specimen was a brown mass consisting of multinucleated giant cells on a fibrous tissue background, and these findings were consistent with a diagnosis of brown tumor...
June 2019: Bone Reports
B Bukva, P D'Hooghe, B Poberaj, K Alkhelaifi, M Hutchinson, P Landreau
PURPOSE: Transverse patellar fractures (TPFs) are uncommon in athletes, and their treatment can be challenging. Stable fixation is commonly achieved by compression screw fixation and stainless steel cerclage wire, but this technique can be associated with complications like nonunion, infection and the need for early hardware removal. We used a combined tension-band (figure-of-eight) braided polyester and suture button technique to treat four athletes who presented with transverse patellar fractures...
January 7, 2019: Musculoskeletal Surgery
Thomas R E Anderson, Philip A Beak, Alex J Trompeter
AIMS: The anatomical safe zone for intra-medullary nail insertion through the tibial plateau is small, insertion outside of this area risks damage to intra-articular structures and poor fracture reduction. The purpose of this retrospective study was to determine if the new supra-patella (SP) approach confers improved nail insertion accuracy, when compared with the standard infra-patella (IP) technique. PATIENTS AND METHODS: Two hundred cases were included in the study (SP 95, IP 105)...
December 20, 2018: Injury
Cesar Cereijo, Basem Attum, Andres Rodriguez-Buitrago, A Alex Jahangir, William Obremskey
Intramedullary nailing is the most popular and widely used method for treating tibial shaft fractures. Intramedullary nailing involves minimal surgical dissection, allowing preservation of blood supply by not disrupting the soft tissue around the fracture. The procedure is performed with the following steps: (1) the patient is positioned supine on the radiolucent operating table with a bump under the ipsilateral hip; (2) a 4 to 6-cm longitudinal incision is made 2 to 4 cm directly proximal to the superior pole of the patella; (3) the quadriceps tendon is sharply incised at its midline and split longitudinally; (4) a cannula device with a blunt trocar and protective sleeve is inserted into the knee joint between the articular surface of the patella and the trochlea of the distal part of the femur, after which a second pin can be inserted through the cannula device and into the distal part of the femur to stabilize the cannula and keep it from backing out; (5) a 3...
September 28, 2018: JBJS Essential Surgical Techniques
Omar A Behery, Oren I Feder, Bryan G Beutel, David H Godfried
Introduction: Isolated tibial tubercle fractures or patellar tendon ruptures are common injuries in adolescents. However, combined tubercle fractures with patellar tendon ruptures are rare, and hence, there are no definitive methods of surgical fixation or post-operative protocols. Case Report: A 13-year-old healthy girl sustained an extensor mechanism injury after the left knee hyperflexion during a fall from skateboarding. On examination, the extensor mechanism was not functional against gravity...
May 2018: Journal of Orthopaedic Case Reports
Xiang-Feng Xu, Peng-He Liu, Long Yue, Le Kang, Zhi-Peng Dai
OBJECTIVE: To explore the clinical curative effect of soft tissue wire rivet for the treatment of fracture of patella cartilage. METHODS: A retrospective study was conducted in 25 patients(25 knees) from June 2015 to February 2017 in patients with patellar cartilage fractures. Among them, 19 were male, 6 were female, 11 were left knee, 14 were right knee. The accident occurred in 2 cases, 23 cases of sprained athletes; the average age was(25.12±6.02) years old, the average weight was (62...
December 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Pierluigi Antinolfi, Francesco Manfreda, Giacomo Placella, Julien Teodori, Giuliano Cerulli, Auro Caraffa
Total knee arthroplasty (TKA) is the best treatment for advanced knee osteoarthritis and it has proven to be durable and effective. Anterior knee pain (AKP) is still one of the most frequent complications after TKA, but sometimes no recognized macroscopic causes can be found. The correct treatment of patella is considered the key for a proper management of AKP. The inclusion of patellar resurfacing during TKA has been described as a potential method for the reduction of AKP. After surgeons started to resurface the patella, new complications emerged, such as component failure, instability, fracture, tendon rupture, and soft tissue impingement...
September 2018: Joints
Takahiro Tsushima, Harehiko Tsukada, Shizuka Sasaki, Takuya Naraoka, Yuji Yamamoto, Eiichi Tsuda, Yasuyuki Ishibashi
BACKGROUND: With the use of synthetic materials for medial patellofemoral ligament (MPFL) reconstruction, graft harvest is not necessary and this may facilitate post-operative rehabilitation. The purpose of this study was to compare the structural properties of MPFL reconstruction using a modern synthetic material (FiberTape® (FT), Arthrex) with knotless anchors or a semitendinosus (ST) tendon autograft with soft anchors. METHODS: Nine human fresh-frozen amputated knees were used in this study...
December 18, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
V Schütte, A Schmidt-Hebbel, A B Imhoff, A Achtnich
OBJECTIVE: Transosseous augmentation of patellar sleeve fractures (PSF) with suture tape in young athletes. INDICATIONS: Acute avulsions of the proximal or distal patellar pol with clinical relevant deficit of knee extension. CONTRAINDICATIONS: Local infections, severe soft tissue damage (relative contraindication), fractures of the patella or tibial tuberosity. SURGICAL TECHNIQUE: Direct longitudinal anterior approach to the patella...
February 2019: Operative Orthopädie und Traumatologie
Romain Gaillard, Christopher Bankhead, Nicolaas Budhiparama, Cécile Batailler, Elvire Servien, Sébastien Lustig
BACKGROUND: The aim of this study is to assess clinical results of total knee arthroplasty (TKA) with pre-operative patella alta or patella baja, compared to TKA with pre-operative normal patellar height. METHODS: Patella height was measured using the Blackburne-Peel (BP) method in an initial, prospective cohort of 4103 TKAs performed at a single center. Three groups were defined: normal patella height (0.54 < BP index ≤ 1.06), patella alta (BP index >1...
November 8, 2018: Journal of Arthroplasty
Onur Kocadal, Murad Pepe, Zafer Gunes, Ertugrul Aksahin, Semra Duran, Cem Nuri Aktekin
In this biomechanical study, the strength of five different fixation techniques -anterior tension band wiring with K-wires, separate vertical wiring, headless compression screws with anterior tension band wiring, cannulated screws with tension band wiring and memory shape patellar fixator- for distal patellar fractures were compared. Forty calf knees were used for the biomechanical testing. Each specimen was pre-loaded with 10 N at 1 N/s. The distraction forces were applied consistently with the velocity of 5 mm/s...
December 2017: Acta Orthopaedica Belgica
De-Shuai Gu, Ren Zhu, Wen-Jun Yu, Li-Wen Zhang
OBJECTIVE: To explore therapeutic effect of absorbable net-sliding intertexture with tension band wiring in treating comminuted fracture of distal patella pole. METHODS: From January 2012 to December 2016, 80 patients with comminuted fracture of distal patella pole were treated with absorbable net-sliding intertexture with tension band wiring, including 45 males and 35 females aged from 25 to 60 years old with an average of(45.0±2.0) years old. All fractures were freshly closed...
October 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Alex A Johnson, Elizabeth L Wolfe, Douglas N Mintz, Shadpour Demehri, Beth E Shubin Stein, Andrew J Cosgarea
Background: Tibial tuberosity osteotomy (TTO) is a versatile procedure commonly used to treat patellar instability as well as to unload cartilage lesions. TTO with concomitant distalization (TTO-d) may be performed in patients with patella alta to stabilize the patella by helping it to engage in the trochlea earlier during flexion. Purpose: To identify and compare perioperative complications in patients who underwent TTO and those who underwent TTO-d and to analyze risk factors associated with these complications...
October 2018: Orthopaedic Journal of Sports Medicine
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