Evaluation of the results of treatment of transverse patellar fractures with cancellous screws

ABSTRACT

Tension band wiring [TBW] is the most common method used to treat displaced transverse patellar fractures. While TBW is very efficient to compress the fracture during knee flexion, it is not that effective during knee extension. The aim of this study is to evaluate the results of treatment of transverse patellar fractures with cancellous screws. Twenty patients with displaced transverse patellar fractures were treated by open reduction and fixation by small set cancellous screws. The mean age of patients was 36.6 +/- 1 7.4 years. There were sixteen males. Road traffic accidents accounted for the majority of trauma. The mean time lapse before surgery was 4.5 days. Two screws were used in sixteen, three screws in three and four screws in one patient. The mean time to clinical union was 9 +/- 2.3 weeks while the mean time to radiological union was 13 +/- 3.6 weeks. All Patients completed six months follow up period. Using a modified Hospital for Special Surgery [HSS] knee scoring system, thirteen patients were excellent, five good and two fair results. Patients improved throughout the follow up period. Results were not affected by age, sex, time lapsed before the operation, and the number of screws used. Complications included prominent hardware in one patient, limited range of movements in six patients in which one developed 20° extensor lag. We concluded that the use of cancellous screws in the treatment of transverse patellar fractures yielded satisfactory outcome with low rate of complications in most cases