Treatment of Comminuted Patellar Fracture: Are There Differences between Performing or Not Performing an Eversion?

Abstract

Purpose To compare the clinical, functional and imaging outcomes of two surgical techniques for the treatment of comminuted patellar fractures: with and without eversion.

Methods In a retrospective series of cases of comminuted patellar fractures treated at a single center between 2014 and 2017, with a follow-up ≥ 3 months , we performed a comparison between the eversion group and the non-eversion group eversion. The exclusion criteria were partial or total patellectomy, tendon reinsertion, or incomplete rehabilitation. The variables analyzed were age, gender, smoking, diabetes mellitus, the energy of the accident, the fracture type, surgical variables (tension band, screws, wires, knots, circular cerclage), postoperative joint range of motion (ROM), presence of symptomatic osteosynthesis, the scores on the functional scales (of Tegner-Lysholm and of Kujala) at the final discharge, complications (joint stiffness, infection, deep vein thrombosis), and pre- and postoperative computed tomography imaging variables (gap, step-off  > 2mm, intra-articular fixation elements).

Results In total, 20 out of 22 patients, 13 undergoing eversion and 7 not undergoing eversion, met the selection criteria.. The follow-up ranged from 3 to 12 months, and there were no statistically significant differences regarding the demographic variables between both groups, which makes them comparable. The most remarkable results were the time from admission to final discharge, of 7 months for the patients in the eversion group, and of 5 months for those in the non-eversion group (p = 0.032), the proportion of patients with a step-off > 2 mm, with 7.7% for the eversion group and 14.3% for the non-eversion group (p = 0.016), and a tendency towards higher scores in the functional scales for the eversion group.

Conclusion The treatment of comminuted patellar fractures with eversion seems to be a viable alternative, given its superior imaging and functional results compared to those of the usual technique.

Keywords

patellar fracture - patellar eversion - comminuted fracture - tension band

Ethical Responsibilities

Protection of people and animals: the authors declare that no experiments were performed on humans or animals for this research.

Confidentiality of the data: the authors declare that they have followed the protocols of their work center on the publication of patient data.

Right to privacy and informed consent: the authors declare that no patient data appear in this article.

Publikationsverlauf

Eingereicht: 04. Juni 2020

Angenommen: 06. August 2021

Artikel online veröffentlicht:
22. Dezember 2021

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