Lessons learned using screws and cable in patellar fractures

Abstract

The patella is an important component of the extensor mechanism of the knee. Displaced patellar fractures need to be fixed. Several techniques for internal fixation have been employed. The aim of this work was to evaluate the results and the lessons learned from treatment of transverse patellar fractures with figure of eight wiring through 4.0mm cannulated screws. Forty patients were included. All were treated by open reduction and internal fixation with this technique. Assessments occurred at 6 weeks, 3 months and 12 months using a modified Hospital for Special Surgery (HSS) knee scoring system. The final results showed twenty-eight patients (70%) had excellent results, ten patients (25%) good results and two patients (5%) fair result. There was a statistically significant improvement of the patients' score throughout the follow up period. The complications that occurred included knee pain in one patient (2.5%) and loss of terminal flexion in three patients (7.5%). There were no cases with extension lag. Treatment of patellar fractures using figure of eight wiring through cannulated screws is a reproducible technique, which gives good stability leading to good results with a low complication rate.