Short term outcome analysis of arthroscopy assisted percutaneous osteosynthesis for Patella fractures: A prospective study

Cheralathan, S (2014) Short term outcome analysis of arthroscopy assisted percutaneous osteosynthesis for Patella fractures: A prospective study. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: Patellar fractures constitute about 1% of all skeletal injuries put together. The present standard treatment options available mainly involve open reduction and internal fixation with various types of implants. In spite of good results the disadvantages of open reduction still pose problems. Recent interest in minimally invasive osteosynthesis has given rise to percutaneous techniques in fixation of many fractures. POMC (Percutaneous Osteosynthesis using Modified Carpenter’s) technique in fixation for transverse patellar fractures has shown good results in recent literature. AIM OF STUDY: This study aims to determine the usefulness of a POMC technique for surgical treatment of transverse fractures of patella, with regards to fracture union, functional outcome and being minimally invasive. MATERIALS AND METHODS: This prospective study involved 20 patients with transverse fracture pattern of patella, all were operated by POMC technique, which involves percutaneous reduction and internal fixation for transverse fractures of patella using 4.0 mm cannulated cancellous screws supplemented with percutaneous anterior tension band wiring through the screws, with 18 G stainless steel wire in a horizontal figure of eight configuration with two knots. The above technique involves arthroscopy and fluoroscopy where the former is used in the direct visualisation of the accurate reduction of the articular surface and the latter is used to confirm the same and aid in implant positioning. All patients were subjected to a standard post-operative protocol and followed up for a minimum period of 6 months. They were objectively assessed by clinico-radiological methods and subjectively assessed using Lysholm knee scoring system. RESULTS: The overall results showed that 75% of the patients had excellent results by subjective analysis using the Lysholm knee scoring scale and 90% union rate by clinic-radiological assessment. CONCLUSION: This short term study proves that POMC technique is an effective treatment method for transverse patellar fractures. But still need long term follow-up studies to establish this method as a standard treatment procedure.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Percutaneous osteosynthesis for patella ; Modified Carpenter’s technique ; Arthroscopy assisted internal fixation for patella ; Minimally invasive patella osteosynthesis ; Lysholm knee score in patella fractures.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 18:38
Last Modified: 16 Sep 2017 18:42

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