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patella fracture

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
Jacob L Henrichsen, Spencer K Wilhem, Matthew P Siljander, Jeremy J Kalma, Mark S Karadsheh
Patella fractures comprise 1% of all fractures. Treatment options vary based on fracture displacement, classification, and patient factors. Traditionally, nonoperative treatment has been reserved for nondisplaced fractures. Many operative treatments are available with differing indications and levels of success. Tension band constructs have been the most commonly employed approach to fixation, with cerclage wiring for comminuted fractures. Recently, plate fixation of patella fractures has become more popular...
October 15, 2018: Orthopedics
Anuj Chawla, Ernest Beng Kee Kwek
PURPOSE: Osteopetrosis is a hereditary skeletal disorder in which defective osteoclast function leads to abnormally hard and brittle bones. This study aims to describe the pattern of fractures occurring in this group of patients, possible complications, and strategies to avoid them. METHODS: This is a case series of six osteopetrotic patients with a total of 12 fractures managed in our institution over a period of nine years. Patient records were also reviewed for complications both intra- and post-operatively...
October 4, 2018: International Orthopaedics
Camila Maftoum Cavalheiro, Riccardo Gomes Gobbi, Betina Bremer Hinckel, Marco Kawamura Demange, José Ricardo Pécora, Gilberto Luis Camanho
Osteochondral fracture after acute patellar dislocation in teenagers is relatively common (up to 60% of cases of patellar dislocation), but poorly diagnosed. There are several treatments proposed for this type of injury, but none well defined in the literature. A male patient, 13 years old, with a diagnosis of osteochondral fracture of the lateral femoral condyle after acute dislocation of the right patella. He underwent surgical treatment of the chondral injury, which consisted of suturing of the chondral fragment to the cartilage defect and, in a second approach, reconstruction of the medial patellotibial ligament and medial patellofemoral ligament with autologous flexor graft...
September 2018: Revista Brasileira de Ortopedia
Wassim Zribi, Mohamed Zribi, Ahmed Racem Guidara, Mohamed Ben Jemaa, Ameur Abid, Nabil Krid, Abdessalem Naceur, Hassib Keskes
The spontaneous and simultaneous rupture of both quadriceps tendons is uncommon and has rarely been reported in the literature. The current case involves a 43-year-old man with end-stage renal disease requiring hemodialysis for the past 20 years. The patient experienced bilateral knee pain and swelling and was unable to bear weight. Physical examination revealed bilateral quadriceps tendon defect above the patella and loss of active extension. Although plain radiographs of both knees showed no fracture or widening of the joint space, an inferiorly positioned patella was observed...
September 18, 2018: World Journal of Orthopedics
Peter Larsen, Rasmus Elsoe
INTRODUCTION: The modern literature includes only limited information regarding mortality rates and cumulative survival following patella fractures. The aim was to report the 30-day, six-month, and one-year mortality of patients with patella fractures and compare this to the mortality of a matched reference population. METHODS: All patients who sustained a patella fracture in Denmark between 1996 and 2000 were included in the study. The survival status of these patients was monitored until 2015...
October 2018: Injury
Qiuju Miao, Huanwen Ding, Hong Wang, Qiang Tu, Jiarong Chen, Huiliang Liu
Objective: To evaluate the effectiveness of precise orthormorphia of tibial angulation deformity and shortening deformity by using digital technology combined with external fixator. Methods: Twenty-six cases of tibial angulation deformity combined with shortening deformity were treated between June 2012 and August 2016, including 12 males and 14 females aged from 1 to 19 years with an average age of 16.5 years. There were 6 cases of congenital patella pseudoarthrosis, 1 case of fibrous dysplasia of femur and tibia, 3 cases of limb shortening deformity caused by infantile paralysis, 16 cases of fracture malunion...
August 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
B Thomas, N Binkley, P A Anderson, D Krueger
INTRODUCTION: Total knee arthroplasty (TKA) is increasingly being performed. Distal femur periprosthetic fracture is a potentially catastrophic complication following TKA and existing data document substantial distal femur bone mineral density (BMD) loss following TKA. However, distal femur BMD is virtually never measured clinically as no consensus approach exists. This pilot study's purpose was to define regional BMD variation throughout the femur, suggest standard dual-energy X-ray absorptiometry (DXA) regions of interest (ROIs) and evaluate BMD reproducibility at these ROIs...
August 13, 2018: Journal of Clinical Densitometry
Hannah Louise Morley, Aadhar Sharma, Paul Whittingham-Jones
We describe the case of a 15-year-old girl who presented to the Accident and Emergency Department with right knee pain and a tense effusion following a twist and fall directly onto her right knee. An MRI scan demonstrated that she had an incarcerated dislocated patella with an associated patella avulsion fracture. This required open reduction. Open reduction and fixation was performed using suture anchors. We feel that this case is particularly pertinent since nearly all previous case reports describe an incarcerated patella with an associated femur fracture...
September 14, 2018: BMJ Case Reports
Nabil Alassaf
Objectives: Diagnosis of Sinding-Larsen-Johansson disease may not be an easy task. Several sport-related conditions affect the distal pole of the patella in the adolescent, and treatment varies considerably. The article describes a patient that had radiographic features of Sinding-Larsen-Johansson disease associated with an atypical acute presentation. Methods: Case report and literature review. Results: A 10-year-old boy presented with a sudden pain after a noncontact soccer injury...
2018: SAGE Open Medical Case Reports
Jordane Mouton, Romain Gaillard, Christopher Bankhead, Cécile Batailler, Elvire Servien, Sébastien Lustig
BACKGROUND: Management of severe varus deformity requires soft tissue balancing for implantation of low-constraint knee prosthesis. Patellar complications have been rarely studied in this specific group. Our hypothesis was that severe genu varum (>15°) would increase the rate of patellar complications. METHODS: Using a prospective cohort of 4216 prostheses performed at a single center beginning in 1987, we analyzed 280 prostheses having preoperative varus greater than 15°, compared to 673 total knee arthroplasties (TKAs) with a preoperative hip-knee-ankle angle of 180° ± 2°...
August 7, 2018: Journal of Arthroplasty
Yinwang Zhang, Zhen Xu, Wuxue Zhong, Fuhai Liu, Jie Tang
BACKGROUND: To compare the efficacy and safety of K-wire tension band fixation (KTB) with other alternative approaches (cannulated screws, cable pin, and ring pin) for treatment of patella fractures by performing a meta-analysis. METHODS: PubMed and EMBASE databases were searched for all relevant studies. Standardized mean difference (SMD) or relative risk (RR) and their corresponding 95% confidence intervals (CIs) were calculated for continuous or dichotomous outcomes via either a fixed- or random-effect model using Stata 13...
September 5, 2018: Journal of Orthopaedic Surgery and Research
Sang Jun Song, Se Gu Kang, Cheol Hee Park, Dae Kyung Bae
Purpose: The purposes of this study were to compare clinical results after total knee arthroplasty (TKA) using the Attune and PFC Sigma knee designs and to investigate whether the use of the Attune prosthesis increased the risk of patellar injury in Asian patients. Materials and Methods: Three hundred knees that underwent TKA using Attune (group A) were compared to 300 knees that underwent TKA using PFC Sigma (group B). The Knee Society knee score (KS) and function score (FS), and range of motion (ROM) were compared...
August 31, 2018: Knee Surgery & related Research
Hatice Tuba Sanal, Christian Krestan, Mark Schurz
Related to fractures of and around the knee, inappropriate technical factors related to the surgery, severe comminution of the fracture, early overly arduous rehabilitation of the patient, and patient-related noncompliances may have the potential for the risk of inadequate fixation and other complications. Loss of fixation, malunion/nonunion, infection, arthritis, arthrofibrosis, and symptomatic hardware are among postsurgical complications that may necessitate further reconstructive techniques. In this review, complications that may be encountered in the postsurgical period of fractures involving the patella, supracondylar femur, and tibial plateau are described...
September 2018: Seminars in Musculoskeletal Radiology
Avinesh Agarwalla, Richard Puzzitiello, Grant H Garcia, Brian Forsythe
Anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone-patellar tendon-bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium phosphate (β-TCP), have been previously used to fill the bony defect in fractures as well as removal of bony tumors, and have shown positive utility in improving anterior knee pain after ACL reconstruction...
July 2018: Arthroscopy Techniques
Alisa Alayan, Ruben Maldonado, Landon Polakof, Atul Saini, Melodie Metzger, Carol Lin, Charles Moon
The traditional technique for patella fracture fixation utilizes prominent hardware. Prominent hardware use, however, results in a high rate of reoperation for symptomatic implant removal. This biomechanical study evaluates the effectiveness of a novel patella fixation technique that minimizes implant prominence. Patellar transverse osteotomies were created in 13 pairs of cadaveric knees. Paired knees were assigned to either standard fixation (SF) using cannulated partially threaded screws and stainless steel wire tension band, or buried fixation (BF) using headless compression screws with a No...
July 2018: American Journal of Orthopedics
Louis Dagneaux, Raphael Allal, Martine Pithioux, Patrick Chabrand, Matthieu Ollivier, Jean-Noël Argenson
BACKGROUND: Malrotation of the femur is a frequent complication in the management of a diaphyseal fracture. It is often responsible for pain and adverse functional results. Among these complications, contact stress effects on the patellofemoral joint are recognized as predictive factors of impaired results. The purpose of this study was to analyze the effect of malrotation on stress distribution on the patellofemoral joint, using radiological measurement and three-dimensional finite element models...
October 2018: Knee
Chih-Wei Chang, Yen-Nien Chen, Chun-Ting Li, Yu-Hsuan Chung, Chih-Han Chang, Yao-Te Peng
PURPOSE: Clinical and biomechanical studies have reported that using supportive screws and a wire instead of the common Kirschner wires for modified tension band wiring improves the stability of fractured patellae. However, the effect of screw proximity on the fixation of a fractured patella remains unclear. Therefore a numerical study was conducted to examine the effects of screw proximity on biomechanical responses in a simulated patellar fracture fixed using two parallel cannulated screws and anterior tension band wiring...
May 2018: Journal of Orthopaedic Surgery
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