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https://www.readbyqxmd.com/read/27905071/imaging-of-patellar-fractures
#1
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...
November 30, 2016: 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
#2
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...
November 17, 2016: Injury
https://www.readbyqxmd.com/read/27876283/importance-of-trabecular-anisotropy-in-finite-element-predictions-of-patellar-strain-after-total-knee-arthroplasty
#3
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...
November 18, 2016: 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
#4
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
#5
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
#6
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...
October 31, 2016: Knee
https://www.readbyqxmd.com/read/27798714/patellar-sleeve-fracture-with-ossification-of-the-patellar-tendon
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27650016/-abstracta-woman-with-knee-pain-after-a-fall-in-childhood
#13
J H J van Erp, R W Brouwer
A 32-year-old woman presented with pain in her left knee ever since she had fallen down the stairs as a child and had landed on this knee. On the X-ray we saw two large patella fragments. We made the diagnosis of dislocated and subluxated fracture of the patella without consolidation. The previously missed fracture was treated conservatively.
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27615323/increased-mortality-after-lower-extremity-fractures-in-patients-65-years-of-age
#14
Axel Somersalo, Juha Paloneva, Hannu Kautiainen, Eija LÖNnroos, Mikko HEinÄNen, Ilkka Kiviranta
Background and purpose - The association between mortality and lower extremity fractures (other than hip fractures in older individuals) is unclear. We therefore investigated mortality in adults of all ages after lower extremity fractures that required inpatient care. Patients and methods - Diagnosis code (ICD10), procedure code (NOMESCO), and 7 additional characteristics of patients admitted to the trauma ward at Central Finland Hospital were collected between 2002 and 2008 (n = 3,567). Patients were followed up until the end of 2012...
December 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27590642/does-the-utilization-of-allograft-tissue-in-medial-patellofemoral-ligament-reconstruction-in-pediatric-and-adolescent-patients-restore-patellar-stability
#15
Eric Hohn, Nirav K Pandya
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents. QUESTIONS/PURPOSES: (1) Does allograft tissue in MPFL reconstruction in pediatric and adolescent patients restore patellar stability? (2) What complications were associated with allograft MPFL reconstructions in children and adolescents? METHODS: Between June 2012 and August 2015, one surgeon (NKP) performed 26 MPFL reconstructions in 23 patients with gracilis allograft for traumatic patellar instability...
September 2, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27576878/arthroscopic-lysis-of-adhesions-improves-knee-range-of-motion-after-fixation-of-intra-articular-fractures-about-the-knee
#16
Daniel Gittings, Patrick Hesketh, Jonathan Dattilo, Miltiadis Zgonis, John Kelly, Samir Mehta
BACKGROUND: Post-traumatic stiffness after open reduction and internal fixation of fractures about the knee can have dramatic effects on function. Traditionally, open quadricepsplasty has been the treatment of choice, but is associated with significant morbidity. PURPOSE: The purpose of this study is to examine the immediate and sustainable range of motion (ROM) changes after surgical arthroscopic lysis of knee adhesions (SALKA) for post-traumatic knee stiffness after open reduction internal fixation (ORIF)...
August 30, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27564684/difficult-patella-fractures-treated-with-the-multiple-wire-and-tension-band-technique
#17
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 that 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 utilizes additional wires and multiple tension bands to gather and fix comminuted fracture patterns in non-transverse planes, bolster osteoporotic bone, and secure fractures in patients undergoing a revision and/or have potential to be poorly compliant with postoperative activity restrictions...
August 24, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27461777/comparison-between-suprapatellar-and-parapatellar-approaches-for-intramedullary-nailing-of-the-tibia-cadaveric-study
#18
Rodolfo Zamora, Craig Wright, Adam Short, David Seligson
: Intramedullary nailing is one viable option for treating fractures of the tibia with a short, proximal segment. For a procedure being carried out with the knee in a semi-extended position, either a suprapatellar or parapatellar approach may be used. The objective of this study is to demonstrate whether the entry point for tibia nails is obtainable through suprapatellar or parapatellar approaches and to evaluate the most frequent injuries of the knee with these two approaches. MATERIALS AND METHODS: Paired legs from 10 fresh frozen cadavers were used...
October 2016: Injury
https://www.readbyqxmd.com/read/27441934/low-profile-mesh-plating-for-patella-fractures-video-of-a-novel-surgical-technique
#19
Diederik O Verbeek, Lindsay E Hickerson, Stephen J Warner, David L Helfet, Dean G Lorich
Patella fractures can be challenging to treat particularly in the presence of inferior pole comminution. In this video we present a novel surgical technique for the treatment of patella fractures using a small fragment low profile mesh plate. Key points are the surgical exposure with direct visualization of the articular reduction, the preparation of the mesh plate to accommodate patellar anatomy and the augmentation of the construct using Krackow sutures to address inferior pole comminution. Low profile mesh plating allows for multiplanar fixation of patella fractures while avoiding implant and fixation problems related to tension band fixation...
August 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27435484/-plate-osteosynthesis-after-patellar-fracture-the-technique-and-initial-results-of-a%C3%A2-prospective-study
#20
A Ellwein, H Lill, G Jensen, A Gruner, J C Katthagen
BACKGROUND: Tension band wiring after patellar fractures is related to a high number of implant-related complications (22-53 %). Revision surgery is necessary in 10-55 % of patients mostly with unsatisfactory results. The patella plate is an alternative treatment with the advantages of locked plating. The purpose of this study was to evaluate the first clinical prospective results and complications of this new implant. MATERIALS AND METHODS: Between April 2013 and May 2015 all patients that were treated with locked plating for patella fractures were included in this prospective study...
July 19, 2016: Der Unfallchirurg
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