Fixed-angle plates in patella fractures - a pilot cadaver study

European Journal of Medical Research

M Hakimi¹  J Windolf¹  D Miersch¹  M Betsch¹  P Jungbluth¹  S Thelen¹  M Wild¹ 

[1] Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Düsseldorf, Germany

关键词: knee;    feasibility study;    angle-stable plate;    fixed-angle plate;    Patella fracture;   

Others  :  828514
DOI  :  10.1186/2047-783X-16-1-41

 received in 2010-01-27, accepted in 2010-02-08,  发布年份 2011

【 摘 要 】

Objective

Modified anterior tension wiring with K-wires and cannulated lag screws with anterior tension wiring are currently the fixation of choice for patellar fractures. Failure of fixation, migration of the wires, postoperative pain and resulting revision surgery, however, are not uncommon. After preliminary biomechanical testing of a new fixed-angle plate system especially designed for fixation of patella fractures the aim of this study was to evaluate the surgical and anatomical feasibility of implanting such a plate-device at the human patella.

Methods

In six fresh unfixed female cadavers without history of previous fractures around the knee (average age 88.8 years) a bilateral fixed-angle plate fixation of the patella was carried out after previous placement of a transverse central osteotomy. Operative time, intra-operative problems, degree of retropatellar arthritis (following Outerbridge), quality of reduction and existence of any intraarticular screw placement have been raised. In addition, lateral and anteroposterior radiographs of all specimens were made.

Results

Due to the high average age of 88.8 years no patella showed an unimpaired retropatellar articular surface and all were severely osteoporotic, which made a secure fixation of the reduction forceps during surgery difficult. The operation time averaged 49 minutes (range: 36-65). Although in postoperative X-rays the fracture gap between the fragments was still visible, the analysis of the retropatellar surface showed no residual articular step or dehiscence > 0.5 mm. Also in a total of 24 inserted screws not one intraarticular malposition was found. No intraoperative complications were noticed.

Conclusions

Osteosynthesis of a medial third patella fracture with a bilateral fixed-angle plate-device is surgically and anatomically feasible without difficulties. Further studies have to depict whether the bilateral fixed-angle plate-osteosynthesis of the patella displays advantages over the established operative procedures.

【 授权许可】

   
2011 I. Holzapfel Publishers 2011

【 图 表 】

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