Management of displaced inferior patellar pole fractures with modified tension band technique combined with cable cerclage using Cable Grip System |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan 430071, China;2. Department of Surgery, The Affiliated Hospital of Hubei Provincial Government, East 2nd Road, Shuiguohu Road, Wuchang District, Wuhan 430071, China;3. Second Clinical College, Medical School of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan 430071, China;1. Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg, Germany;2. Department of Knee and Shoulder Surgery, Sports Traumatology, Asklepios Clinic St. Georg, Hamburg, Germany;3. "Fracture Committee" of the German Knee Society, Germany;1. Department of Orthopaedic Surgery, Gyeongsang National University, College of Medicine, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, Gyeongsangnam-do, 51472, Republic of Korea;2. Department of Orthopedic Surgey, Samsung Changwon hospital, Sungkyunkwan University, school of medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do, 51353, Republic of Korea;1. Interuniversity Centre for Health Economics Research, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussel, Belgium;2. Medical Registration, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussel, Belgium;3. Emergency and Disaster Medicine, Department Emergency Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussel, Belgium;4. Mobility, Logistics and Automotive Technology Research Centre, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussel, Belgium;5. Interuniversity Centre for Health Economics Research, Faculty of Medicine & Health Science, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium;1. Septic and Reconstructive Surgery Unit, Orthopaedic Surgery Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain;2. Orthopaedic Surgery Department, Hospital Verge de la Cinta, Tortosa, Spain |
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| Abstract: | IntroductionWe present a modified tension band technique combined with cable cerclage using Cable Grip System for the treatment of displaced inferior patellar pole fractures and report the knee functional outcome.Patients and methodsThe patients who had had operative treatment of a displaced inferior patellar pole fracture (AO/OTA 34-A1) between December 2013 and December 2015 were studied retrospectively. Eleven consecutive patients had had open reduction and internal fixation with the modified technique using Cable Grip System, of whom, five males and six females with an average age of 60.9 years (range, 29–81 years). All fractures occurred from direct fall onto the knee. The average time from injury to surgery was 6.1 days (range, 2–12 days). The range of motion (ROM) was measured in degrees by goniometry at postoperative intervals of 1, 2, 4, 12, and 48 weeks; Knee function was evaluated using the Rasmussen scores at final follow-up.ResultsNo patients had nonunion, loss of reduction, migration of wire, irritation from the implant and fixation breakage during the follow-up period. Recovery of ROM was achieved at 12 weeks, with the average ROM at 1 week was 72° (range, 65°–78°), 86.4° (range, 78°–92°) at 2 weeks, 115.5° (range, 103°–122°) at 4 weeks, 129.6° (range, 122°–133°) at 12 weeks, 134.5° (range, 129°–139°) at 48 weeks after the operation. Concerning the knee function outcome assessment, all patients showed excellent results at final follow-up. The average Rasmussen scores was 27.9 out of 30 (range, 27–29).ConclusionsThe modified tension band technique combined with cable cerclage using Cable Grip System for displaced inferior patellar pole fractures can provide stable fixation with excellent results in knee function, allows for immediate mobilization and early weight-bearing, which is a simple and valuable technique in routine clinical practice. |
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| Keywords: | Displaced inferior patellar pole fracture Modified tension-band Cable grip system Titanium cable Cerclage |
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