CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2021; 62(03): e193-e200
DOI: 10.1055/s-0041-1740283
Artículo Original | Original Article

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

Article in several languages: español | English
1  Equipo de Cirugía de Rodilla y Artroscopía, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile
,
1  Equipo de Cirugía de Rodilla y Artroscopía, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile
,
2  Médico Cirujano Epidemiólogo, Mutual de Seguridad C.Ch.C., Santiago, Chile
,
Maximiliano Hube L
3  Residente de Ortopedia & Traumatología, Universidad de Valparaíso/Mutual de Seguridad C.Ch.C., Valparaíso, Chile
,
4  Residente de Ortopedia & Traumatología, Departamento de Traumatología, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile
,
Carolina Mellado M
5  Servicio de Imagenología, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile
,
Gonzalo Espinoza L
1  Equipo de Cirugía de Rodilla y Artroscopía, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile
› Author Affiliations

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.

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.




Publication History

Received: 04 June 2020

Accepted: 06 August 2021

Publication Date:
22 December 2021 (online)

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