Osteosynthesis in Lower Pole of Patella Fracture: A Follow up Study in Churu District of Rajasthan

ABSTRACT

Introduction: Patella is an important component of extensorapparatus and it has a major role in making the extension ofknee efficient. Patella fracture accounts for 1% of all fractures.Treatment options for fracture of lower pole of patella areTension Band Wiring, Circumferential Wiring or with screw ifthe fragment is large enough. Tension Band Fixation involvesboth static and dynamic forces.Objectives: To assess the functional outcome ofosteosynthesis in fracture of lower pole of patella usingTension band Wiring technique.Materials and Methods: The present study was a follow-upstudy conducted in Churu Multispecialty Hospital and ResearchCenter, Churu during Sept 2017 to April 2019. All the patientswith lower pole of patella fracture and whose age was 16 ormore were included in the study. Tension Band wiring is donein all the 15 patients under spinal anesthesia. Patients werefollowed at 1, 6 and 12 weeks after the date of surgery.Patients were evaluated according to Bostman’s method ofclinical grading of knee scoring system and patients weregraded as excellent, poor or unsatisfactory depending on thescore obtained.Results: In present study maximum patellar fractures were inage group 31 to 50 years. Most of the patients in our studywere males. All the variables like flexion loss, extension loss,pain, quadriceps atrophy, effusion, giving way andstair climbing improved in all the cases at final follow-up. Onepatient was lost to follow-up at 12 weeks. Clinical grading alsoimproved and 12 out of 14 patients had excellent scoring atfinal follow-up. Superficial infection developed in one patientand that was recovered fully after antibiotic coverage. Onepatient developed kneeling discomfort and that was alsorecovered at 12 week of follow-up.Conclusion: Osteosynthesis using tension band wiringtechnique is a viable treatment option lower pole fracture ofpatella with good functional results despite the technicaldifficulty associated with this procedure.