Treatment of patellar fractures with cable through the bone and Kirschner with a hole in the tail / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To study clinical effects of a new internal fixation by using a cable through the bone and Kirschner with a hole in the tail, for the treatment of patellar fractures.</p><p><b>METHODS</b>From May 2012 to July 2013, thirty-four patients with patellar fractures were treated with cable through the bone and Kirschner with a hole in the tail. All the patients had close fracture,including 12 transverse fractures and 22 comminuted fractures. There were 18 males and 16 females, ranging in age from 26 to 81 years old, with an average of (46.0 ± 3.0) years old. After open reduction, two appropriate length of Kirschner with a hole in the tail were driven into the patella as perpendicular to the fracture line or the major fragments as possible. A transverse bone tunnel was then drilled with a Kirschner at one side of the patella. Then the cable, which was successively pulled through the bone tunnel and the hole of Kirschner, was crossed in a figure-eight over the anterior of the patella, tightened and fixated by special instruments. The Kirschner was clipped off on the edge of the hole. If it was a comminuted fracture, another cable was used to fasten the patella with cerclage. Postoperative evaluation was based on Bostman.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 12 to 26 months, with a mean of (16.0 ± 2.0) months. Fractures healed in all the cases without such complications as infection, loosening of Kirschner and cable loop, and skin irritation. According to the Böstman score system, 33 cases got an excellent result, and 1 good.</p><p><b>CONCLUSION</b>The cable through the bone and Kirschner with a hole in the tail is a simple, stable and effective method for the treatment of patellar fractures, especially the transverse fractures, with earlier knee exercise and fewer complications.</p>