Objectives: To review comminuted patella fracture in the elderly patients and examine the surgical options to avoid complications such as fixation failure and poor functional outcome. To provide an example of mesh augmentation in comminuted patella fracture in the elderly patients.
Data Sources: A literature review was conducted by the authors independently using Ovid, Medline, Cochrane, PubMed, and Clinical Key in English. We aimed to review data on patients older than 65 with comminuted patella fracture. Search conducted between July and December 2015.
Study Selection: Search terms included patella fracture, elderly, and fixation failure. Abstracts were included if they were a case report, cohort series, or randomized control trial. Further inclusion criteria were that they were available in full text and included patient age(s), operative details, follow-up, and outcome discussion.
Data Extraction: Each study was assessed according to its level of evidence, number of patients, age of patients, fracture patterns described, complications of treatment, and results summarized.
Data Synthesis: Paucity of data and heterogeneity of studies limited statistical analysis. Data are presented as a review table with the key points summarized.
Conclusion: In patella fracture, age >65 years and comminuted fracture pattern are predictors of increased fixation failure and postoperative stiffness, warranting special consideration. There is a trend toward improved functional outcomes when augmented fixation using mesh or plates is used in this group. Further level 1 studies are required to compare and validate new treatment options and compared them to standard surgical technique of tension band wire construct.
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http://dx.doi.org/10.1177/2151458517710517 | DOI Listing |
BMC Musculoskelet Disord
December 2024
Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, Geneva, CH-1205, Switzerland.
Purpose: Trochlear dysplasia is found in 3.2% (95% confidence interval (CI) 1.2-6.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
University Hospital Regensburg, Regensburg, Germany.
Introduction: Patellar fractures are rare at 1% incidence of all fractures. However, they can cause significant functional impairments due to the patella's role in knee joint extension. Current scoring systems lack objectivity in assessing patellar healing.
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2024
The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Background: Patellar fractures present challenges in treatment, with traditional methods often leading to complications such as loss of reduction and implant failure. This study aimed to compare a novel suture fixation technique with the traditional tension band method using finite element analysis.
Methods: CT images of a healthy 35-year-old male were used to construct 3D patellar models.
J Orthop Surg Res
December 2024
Department of Orthopedic Surgery, Baoding First Central Hospital of Hebei Medical University, Baoding, China.
Background: Patellar fractures are a common knee injury among elderly patients, with a high risk of developing surgical site infections (SSI) postoperatively, which severely affects patient prognosis and quality of life. Elderly patients are more susceptible to SSI due to various factors such as decreased immune function and chronic diseases. Therefore, identifying the risk factors for SSI is of great clinical significance for prevention.
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
Department of Clinical Laboratory, Shengli Oilfield Central Hospital, No. 31 Jinan Road, Dongying, Shandong, 257034, China.
Background: To compare the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in treating fractures at the tibial metaphyseal-diaphyseal junction.
Methods: A retrospective analysis was conducted on the clinical data of 45 patients with proximal or distal tibial fractures treated with intramedullary nailing via lateral parapatellar approach (n = 23) or infrapatellar approach (n = 22) between January 2019 and March 2023. We recorded and compared the operative time, intraoperative blood loss/fluoroscopies, success rate of closed reduction, anteroposterior and lateral entry point accuracy, postoperative infection, fracture healing time, as well as NRS pain scores, Lysholm knee function scores, and knee range of motion.
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