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Separate vertical wiring for the fixation of comminuted fractures of the inferior pole of the patella.

Authors
 Hyung Keun Song  ;  Je Hyun Yoo  ;  Young Soo Byun  ;  Kyu Hyun Yang 
Citation
 YONSEI MEDICAL JOURNAL, Vol.55(3) : 785-791, 2014 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2014
MeSH
Aged ; Aged, 80 and over ; Bone Wires* ; Female ; Fracture Fixation, Internal/methods ; Fractures, Comminuted/surgery* ; Humans ; Male ; Middle Aged ; Osteotomy ; Patella/injuries* ; Patella/surgery*
Keywords
Patella ; cerclage wiring ; inferior pole ; vertical wiring
Abstract
PURPOSE: Among patients over 50 years of age, separate vertical wiring alone may be insufficient for fixation of fractures of the inferior pole of the patella. Therefore, mechanical and clinical studies were performed in patients over the age of 50 to test the strength of augmentation of separate vertical wiring with cerclage wire (i.e., combined technique).
MATERIALS AND METHODS: Multiple osteotomies were performed to create four-part fractures in the inferior poles of eight pairs of cadaveric patellae. One patella from each pair was fixed with the separate wiring technique, while the other patella was fixed with a combined technique. The ultimate load to failure and stiffness of the fixation were subsequently measured. In a clinical study of 21 patients (average age of 64 years), comminuted fractures of the inferior pole of the patellae were treated using the combined technique. Operative parameters were recorded from which post-operative outcomes were evaluated.
RESULTS: For cadaveric patellae, whose mean age was 69 years, the mean ultimate loads to failure for the separate vertical wiring technique and the combined technique were 216.4±72.4 N and 324.9±50.6 N, respectively (p=0.012). The mean stiffness for the separate vertical wiring technique and the combined technique was 241.1±68.5 N/mm and 340.8±45.3 N/mm, respectively (p=0.012). In the clinical study, the mean clinical score at final follow-up was 28.1 points.
CONCLUSION: Augmentation of separate vertical wiring with cerclage wire provides enough strength for protected early exercise of the knee joint and uneventful healing.
Files in This Item:
T201404987.pdf Download
DOI
10.3349/ymj.2014.55.3.785
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138598
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