Volume 12 | Issue 4 | Oct-Dec 2017 | Page 20-23 | Sarabjeet Singh Kohli, Nilesh Vishwakarma, Shaival Chauhan
Authers: Sarabjeet Singh Kohli , Nilesh Vishwakarma , Shaival Chauhan .
Department of Orthopaedics, MGM Medical College, Kamothe, Navi Mumbai. Maharashtra 410210.
Address of Correspondence
Dr. Sarabjeet Singh Kohli,
602, Siddhi grandeur, plot no 84,sector 19, kharghar.Navi mumbai. 410210.
Background: The patellar tendon length can change following surgical treatment of lower pole patella fractures. The commonly used parameters among many to assess the changes are Insall-Salvati ratio and Black-burne peel index. The changes in the parameters would have implication on the patella-femoral biomechanics. The clinical and radiological changes may be dependent on one another. Multiple complications are present in each of the technique used to fix such fractures. The study was undertaken to evaluate the short term clinical and radiological results of alteration in the patellar tendon length after trans-osseous fixation with pull through sutures of lower pole patella fractures. 30 patients were evaluated clinically with Kujala score, Insall-Salvati ratio and Black-burne peel index. The patients had a final mean range of movement 152 degrees (mean 134-170 degrees). The mean time required to recover full range of motion following discontinuation of immobilizer was 18 weeks (range 15.5 to 22 weeks). The Kujala score was 93 after 1year and the changes in the patellar tendon length was present in majority but was not statistically significant. The conclusion was derived that although the changes in patella tendon length after surgical treatment is common but the short term clinical implications are not evident.
1. Bibbo C, Milia MJ, Gehrmann RM, Patel DV,Anderson RB. Strength and knot security of braided polyester and caprolactone/glycolide suture. Foot Ankle Int 2004;25:712-715.
2. Chang SM, JL XL. Open reduction and internal fixation of displaced patella inferior pole fractures with anterior tension band wiring through cannulated screws. J Orthop Trauma. 2011 Jun;25(6):366-70.
3. Goble EM, Somers WK, Clark R, Olsen RE. The development of suture anchors for use in soft tissue fixation to bone. Am J Sports Med 1994;22:236-239.
4. Gaines RJ, Grabill SE, DeMaio M, Carr D. Patellar tendon repair with suture anchors using a combined suture technique of a Krackow-Bunnell weave. J Orthop Trauma 2009;23:68-71.
5. Gosal HS,Singh P,Field RE:Clinical experience of Patellar fracture fixation using metal wire or non absorbable polyester sutures –a study of 37 cases,Injury 32:129,2001.
6. Ho HM, Lee WK. Traumatic bilateral concurrent patellar tendon rupture: An alternative fixation method. Knee Surg Sports Traumatol Arthrosc 2003;11:105-111.
7. Cary Fletcher. Comminuted Fractures of The Lower Pole of The Patella – To Fix or Resect? A Case Report and Review of the Literature. EC Orthopaedics. 2015;2(1):54-9.
8. Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101:101–104
9. Blackburne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Joint Surg Br 59-B:241–242
10. Saltzman CL, Goulet JA, McClellan RT, Schneider LA, Matthews LS. Results of treatment of displaced patellar fractures by partial patellectomy. J Bone Joint Surg Am. 1990 Oct;72(9):1279-85.
11. Krackow KA, Thomas SC, Jones LC. A new stitch for ligament tendon fixation: Brief note. J Bone Joint Surg Am 1986;68:764-766.
12. Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy. 1993;9:159-163.
13. Patel VR,Parks BG,Wang Y,et al:Fixation of patella fractures with braided polyester sutures:a biomechanical sudy,Injury 31:1,2000.
14. Johnson EE. Fractures of the patella. In: Rockwood C, Green D, Bucholz RW, Heckman JD. (eds). Rockwood and Green’s fractures in adults (4th ed.). Philadelphia: Lippincott-Raven; 1996.p.1956-72.
15. Marder RA, Swanson TV, Sharkey NA, Duwelius PJ. Effects of partial patellectomy and reattachment of the patellar tendon on patellofemoral contact areas and pressures. J Bone Joint Surg Am. 1993 Jan;75(1):35–45.
16. Hung LK, Lee SY, Leung KS, Chan KM, Nicholl LA. Partial patellectomy for patellar fracture: tension band wiring and early mobilization. J Orthop Trauma. 1993;7(3):252-60.
17. Schuett DJ, Hake ME, Mauffrey C, Hammerberg EM, Stahel PF, Hak DJ. Current treatment strategies for patella fracture. Orthopedics. 2015 Jun;38(6):377-84.
18. Cakici H, Hapa O, Ozturan K, Guven M, Yucel I. Patellar tendon ossification after partial patellectomy: a case report. J Med Case Reports. 2010;4:47.
19. Gaines RJ, Grabill SE, DeMaio M, Carr D. Patellar tendon repair with suture anchors using a combined suture technique of a Krackow-Bunnell weave. J Orthop Trauma. 2009 Jan;23(1):68–71.
20. Pelzl H. Partial patellectomy for treatment of multi-fragment fractures of the patella (author’s transl). Unfallheilkunde. 1981 Dec;84(12):514-7
|How to Cite this article: Sarabjeet Singh Kohli SS, Vishwakarma N, Chauhan S. Evaluation of patellar tendon length after lower pole patella fractures . Journal of Trauma and Orthopaedic Surgery Oct – Dec 2017;12(4): 20-23.|