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https://www.readbyqxmd.com/read/28205230/forensic-identification-of-bipartite-patella-misdiagnosed-as-patella-fracture
#1
Jingyuan Ma, Fang Shi, Chongya Huang, Shanzhi Gu
Bipartite patella is recognized as a developmental anomaly of ossification. Most of them are asymptomatic and are discovered incidentally. Bipartite patella is sometimes misdiagnosed as a patella fracture, because the x-ray images of both these conditions may appear very similar. In this case, the patient complained of left knee pain after x-ray films revealed a fracture-like line in the left patella. The patient was then diagnosed as having a patella fracture. In China, the injury degree is categorized as serious injury, minor injury, and trivial injury...
February 15, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28192827/the-use-of-mesh-plates-for-difficult-fractures-of-the-patella
#2
David Volgas, Tina K Dreger
Patella fractures present some of the more complicated fracture patterns in orthopaedic trauma care. This is partially due to the small size of the fragments but also the articular nature of each fragment. Fixation methods such as cerclage wiring, excision of smaller fragments, and screw fixation of larger fragments all have their own challenges. Our study examined our Level I trauma center's experience with variable angle locked 2.7 mm titanium plates for treatment of comminuted patella fractures or treatment of patellar nonunion...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28166170/superior-outcomes-after-operative-fixation-of-patella-fractures-using-a-novel-plating-technique-a-prospective-cohort-study
#3
Dean G Lorich, Peter D Fabricant, Gina Sauro, Lionel E Lazaro, Ryan R Thacher, Matthew R Garner, Stephen J Warner
OBJECTIVE: The purpose of this prospective cohort study was to determine if a new patella fracture fixation construct resulted in improved outcomes compared to traditional tension band techniques. DESIGN: Comparative cohort study. SETTING: Academic level I trauma center. PATIENTS/PARTICIPANTS: Patients with isolated, unilateral patellar fractures were enrolled prospectively. From 2012-2014, 33 patients underwent fixation with a novel plate construct that spans half of the patella circumference laterally and provides multiplanar fixation through a low profile plate...
January 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28129272/revisiting-tension-band-fixation-for-difficult-patellar-fractures
#4
Dustin S Hambright, Kempland C Walley, Amber Hall, Paul T Appleton, Edward K Rodriguez
Patella fractures with comminution, osteoporotic bone, and/or previously failed fixation are exceedingly difficult to reduce and fix. Moreover, the risk of symptomatic constructs and patients who are poorly compliant with postoperative activity restrictions can make these complex fracture patterns an even more challenging scenario. Although there is an array of techniques described for comminuted patella fractures, there lacks an accepted surgical technique for these difficult cases. In this clinical series, we describe an enhancement to the traditional tension band construct that uses additional wires and multiple tension bands to gather and fix comminuted fracture patterns in nontransverse planes, bolster osteoporotic bone, and secure fractures in patients undergoing a revision and/or have potential to be poorly compliant with postoperative activity restrictions...
February 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28124724/number-of-positive-radiographic-findings-in-pediatric-trauma-patients
#5
Thomas Ruffing, Tim Danko, Thomas Henzler, Christel Weiss, Alexander Hofmann, Markus Muhm
PURPOSE: Conventional radiography is frequently performed in pediatric patients in whom fractures and dislocations are suspected. However, until now, the rate of positive findings of the most commonly performed radiographic examinations in pediatric patients is unknown. The aim of this study was to evaluate the number of positive findings in the 20 most frequently requested standard radiographic examinations in pediatric patients in a level 1 trauma center systematically. METHODS: A transversal cohort study was conducted at a level 1 trauma center in Germany (2008-2014)...
January 26, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28116277/broken-pieces-of-circlage-wire-lying-in-soft-tissue-envelope-around-knee-joint-a-case-report-and-review-of-literature
#6
Anoop Kalia, Kavin Khatri, Jagdeep Singh, Kapil Bansal, Mohammed Sagy
INTRODUCTION: The migration of circlage wires used in tension band wiring construct of patella fractures in the posterior soft tissue envelope surrounding the knee joint has been rarely reported. CASE PRESENTATION: A 60-year-old woman presented to us with pain over medial aspect of right knee joint. She underwent open reduction and internal fixation for a patellar fracture which she sustained 4 years back and subsequently underwent kirschner wire(k wire) removal for the same around 2 years back...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28050533/total-ruptures-of-the-extensor-apparatus-of-the-knee
#7
Diogo Moura, Fernando Fonseca
OBJECTIVE: This was a retrospective case-control study on total ruptures of the extensor apparatus of the knee, aimed to compare patella fractures with tendinous ruptures. METHODS: The sample included 190 patients and 198 total ruptures of the knee extensor apparatus. All patients were evaluated by the same examiner after a minimum one-year follow-up. RESULTS: Tendinous ruptures occurred most frequently in men, in younger patients, and had better clinical and functional outcomes when compared with patella fractures; however, the former presented higher levels of thigh atrophy...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27941170/management-of-traumatic-patellar-dislocation-in-a-regional-hospital-in-hong-kong
#8
H L Lee, W P Yau
INTRODUCTION: The role of surgery for acute patellar dislocation without osteochondral fracture is controversial. The aim of this study was to report the short-term results of management of patellar dislocation in our institute. METHODS: Patients who were seen in our institution with patella dislocation from January 2011 to April 2014 were managed according to a standardised management algorithm. Pretreatment and 1-year post-treatment International Knee Documentation Committee score, Tegner activity level scale score, and presence of apprehension sign were analysed...
December 12, 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27905071/imaging-of-patellar-fractures
#9
REVIEW
Mohamed Jarraya, Luis E Diaz, William F Arndt, Frank W Roemer, Ali Guermazi
Patellar fractures account for approximately 1% of all skeletal fractures and may result from direct, indirect, or combined trauma. Because of the importance of patellar integrity for knee extension and the risk of associated injury to the extensor mechanism, accurate reporting and description of fracture type is paramount for appropriate management. This pictorial essay aims to review the normal anatomy of the patella, the mechanisms of injury and different types of patellar fractures, with a brief introduction to therapeutic management...
February 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/27890337/a-double-button-adjustable-loop-device-is-biomechanically-equivalent-to-tension-band-wire-in-the-fixation-of-transverse-patellar-fractures-a-cadaveric-study
#10
Fucai Han, Christopher Jon Pearce, David Q K Ng, Amit K Ramruttun, Desmond Y R Chong, Diarmuid Murphy, Chin Tat Lim, Bernard C S Lee
INTRODUCTION: Tension-band wire fixation of patellar fractures is associated with significant hardware-related complications and infection. Braided polyester suture fixation is an alternative option. However, these suture fixations have higher failure rates due to the difficulty in achieving rigid suture knot fixation. The Arthrex syndesmotic TightRope, which is a double-button adjustable loop fixation device utilizing a 4-point locking system using FibreWire, may not only offer stiff rigid fixation using a knotless system, but may also obviate the need for implant removal due to hardware related problems...
February 2017: Injury
https://www.readbyqxmd.com/read/27876283/importance-of-trabecular-anisotropy-in-finite-element-predictions-of-patellar-strain-after-total-knee-arthroplasty
#11
A Latypova, D P Pioletti, A Terrier
Patellar fracture and anterior knee pain remain major complications after Total Knee Arthroplasty (TKA). Patient-specific finite element (FE) models should help improve understanding of these complications through estimation of joint and bone mechanics. However, sensitivity of predictions on modeling techniques and approaches is not fully investigated. In particular, the importance of patellar bone anisotropy, usually omitted in FE models, on strain prediction is still unknown. The objective of this study was thus to estimate the influence of modeling patellar trabecular anisotropy on prediction of patellar strain in TKA models...
January 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/27842571/medial-patellofemoral-ligament-reconstruction-using-a-bone-groove-and-a-suture-anchor-at-patellar-a-safe-and-firm-fixation-technique-and-3-year-follow-up-study
#12
Hong-De Wang, Jiang-Tao Dong, Shi-Jun Gao
BACKGROUND: Graft fixation is critical to the restoration of the medial patella of femoral ligament function and long-term success. Numerous fixations at the patella have been described, while the complications including patellar fractures, violation of the posterior patella and delay of tendon-to-bone healing remain significant challenges. Here, we describe a safe and firm fixation at the patellar for medial patellofemoral ligament (MPFL) reconstruction and explore the safety angle of drilling the suture anchor at different morphology of the patellar...
November 14, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27833696/ultrasound-detection-of-patellar-fracture-and-evaluation-of-the-knee-extensor-mechanism-in-the-emergency-department
#13
Kiersten Carter, Arica Nesper, Laleh Gharahbaghian, Phillips Perera
Traumatic injuries to the knee are common in emergency medicine. Bedside ultrasound (US) has benefits in the rapid initial detection of injuries to the patella. In addition, US can also quickly detect injuries to the entire knee extensor mechanism, including the quadriceps tendon and inferior patellar ligament, which may be difficult to diagnose with plain radiographs. While magnetic resonance imaging remains the gold standard for diagnostic evaluation of the knee extensor mechanism, this can be difficult to obtain from the emergency department...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27810431/clinical-results-after-treatment-for-bidirectional-patellar-subluxation-minimum-2-years-follow-up
#14
Michael Saper, Candice Brady, Robert Zondervan, David Shneider
BACKGROUND: We describe the preliminary clinical results of a patellar stabilization technique to treat bidirectional patellar subluxation (BPS). METHODS: Patients: six patients (one male, five females; mean age 30.2years) underwent this procedure with a minimum of 24months follow-up. Patients were assessed for clinical instability, patellar complications, and need for revision surgery. Patient functional outcomes were evaluated using the criteria of Crosby and Insall and the Kujala Anterior Knee Pain Scale at the time of final follow-up...
December 2016: Knee
https://www.readbyqxmd.com/read/27798714/patellar-sleeve-fracture-with-ossification-of-the-patellar-tendon
#15
Derek S Damrow, Scott E Van Valin
Patellar sleeve fractures make up greater than 50% of all patellar fractures. They are essentially only seen in the pediatric population because of the thick periosteum and the distal patellar pole apophysis in this group. These fractures can lead to complications if not treated appropriately and in a timely fashion. Complications of missed or untreated patellar sleeve fractures include patella alta, anterior knee pain, and quadriceps atrophy. These can all result in severe limitations in activity. The authors describe a case of a 16-year-old boy who sustained a patellar sleeve fracture 3 years prior to presentation...
October 31, 2016: Orthopedics
https://www.readbyqxmd.com/read/27780503/biomechanical-analysis-of-tension-band-wiring-tbw-of-transverse-fractures-of-patella
#16
Mohammed Ali, Jan Kuiper, Joby John
PURPOSE: Tension band wiring is commonly used for fixation of simple transverse fractures. The popular configuration is parallel Kirschner wires (K-wires) and a stainless steel wire loop placed in a vertically oriented figure-of-8. METHODS: We used a wooden model of a patella with a midway transverse fracture and compared four different types of fixation. The first construct had a vertical figure-of-8 with one twist of wire. The second contained a vertical figure-of-8 with two twists of wire...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27776370/complications-related-to-implant-fixation-of-patellar-fractures-comparison-of-ring-pins-versus-bent-k-wires
#17
Min Gyu Kyung, Seung Hoo Lee, Min Bom Kim
Patellar fractures are characterized by injuries to the extensor and typically require surgical fixation. Among the methods used for fixation, the most common is the modified AO tension-band wiring technique. However, using this technique, implant migration occurs due to the lack of connections between the K-wires and the tension-band wire, which causes irritation and reduces fracture stability. Recently, new methods for tension-band wiring have been developed in which tension bands lock the K-wires through an attached "ring" to prevent migration...
October 24, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27749556/clinical-results-of-treatment-using-a-modified-k-wire-tension-band-versus-a-cannulated-screw-tension-band-in-transverse-patella-fractures-a-strobe-compliant-retrospective-observational-study
#18
Honglue Tan, Pengyi Dai, Yanhao Yuan
It was a retrospective case-control study. The aim of this study was to explore the clinical efficacy and complication of treatment using a modified Kirschner wire tension band (MKTB) or a cannulated screw tension band (CSTB) in transverse patellar fractures.In total, 55 patients with transverse patellar fractures were retrospectively reviewed and divided into 2 groups according to the surgical technique: 29 patients were in the MKTB group and 26 patients in the CSTB group. B[Latin Small Letter o with Caron]stman's clinical grading scale, including range of movement (ROM), pain, ability to work, atrophy of quadriceps femoris, assistance in walking, effusion, giving way, and stair-climbing, was used to evaluate the clinical results...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27703946/open-periprosthetic-patellar-fracture-after-total-knee-replacement
#19
Karim Masmoudi, Yamen Grissa, Sofien Benzarti, Hassen Cheikhrouhou, Zied Mensi
INTRODUCTION: Periprosthetic patellar fracture after total knee arthroplasty (TKA) is a rare complication. Their management can be very challenging with unpredictable results. Literature analysis showed few articles about this complication, but no publication has described the management of open patella fracture around total knee arthroplasty. CASE PRESENTATION: We report a unique case of an open patellar fracture above a total knee arthroplasty, sustained by a 56-year-old female patient...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27672572/total-knee-arthroplasty-for-treatment-of-post-traumatic-arthritis-systematic-review
#20
Hesham Saleh, Stephen Yu, Jonathan Vigdorchik, Ran Schwarzkopf
AIM: To review and report functional outcomes, complications, and survivorship associated with total knee arthroplasty (TKA) in the treatment of post-traumatic arthritis (PTA). METHODS: We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for English-language clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full...
September 18, 2016: World Journal of Orthopedics
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