الفهرس | Only 14 pages are availabe for public view |
Abstract The patella is an important component of the extensor mechanism of the knee. Patellar fractures are relatively uncommon injuries which need to be fixed if displacement occurs more than 2 mm. Transverse fractures comprise the largest category. Patellar fractures are intra-articular fractures which need open reduction internal fixation. Several different techniques for internal fixation have been employed which include the AO modified tension band wiring, interfragmentary screws or figure of eight wiring through cannulated screws. The aim of this work was to compare the results of fixation of the patellar fractures by the traditional tension band fixation using kirshner wires versus figure of eight wiring through cannulated screws. This prospective study compared the results of treatment of 30 adults patients with transverse patellar fractures by two methods of treatment at El Menofia University Hospital .The patients were divided into two groups(I,II) on a random selection . I- group I: including 15 patients treated with the kirschner wires and tension band wiring . II- group II: including 15 patients treated with cannulated screw with tension band wiring. The final results was evaluated according to modified HSS knee score ,after six months of follow up . On admission all patients were assessed by history taking, clinical examination and radiological assessment. In this study the mean age of patients were 36.40 ± 12.78 years .There were 1 females (6.7%) and 14 males (93.3%), the right side was fractured in 12 patients (80%), while left side was fractured in 3 patients (20%), the mechanism of trauma was severe trauma in ten patients (66.7%), 2 patients were fractured due to moderate trauma(13.3%), and 3 patients were fracture due to mild trauma (20%).the mean time of radiological union was 8.0±2.27 weeks. The final results of the study as regarding the modified HSS knee scoring system included 5 patients (33.3%) had excellent results, 7 patients (46.7%) good result , 3 patients (20%) had fair result and no patient had a poor result . There was a statistically significant difference in the modified HSS score of both groups . There was no statistically significant difference relation between age, sex, side affected, occupation , mechanism of trauma and final result. The complications occurred included 2 patients lost 10 degree of terminal flexion of knee (13.3%), 1 patient lost 20 degree (6.6%). 3 patients lost 30 degree (20%) ,There were no cases with extension lag in this series, 9 patients had irritation by long kirshner wires , 2 patients had superficial infections. In this study the mean age of the patients were 38.60 ± 11.75 years.There were 2 (13.3%) females and 13 males (86.7%),11 patients (73.3%) had right side fractures, and 4 patients (26.7%) had left side fractures ,the mechanism of trauma was severe trauma in nine patients (60%), 2 patients were fractured due to moderate trauma(13.3%) and 4 patients were fracture due to mild trauma. (26.7%).the mean time of radiological union was 7.07±1.03 weeks. The final results of the study as regarding the modified HSS knee scoring system included 12 patients (80%) had excellent results , 3 patients (20%) good result , no patients had fair result and no patient had a poor result. There was a statistically significant difference in the modified HSS score . There was no statistically significant relation between age, sex, side affected, occupation , mechanism of trauma and final result. The complications occurred included 1 patient lost 10 degree of terminal flexion of knee (6.6%), 2 patients lost 20 degree (13.3%). There were no cases with extension lag in this series, 2 patients had irritation by long screws , 3 patients had superficial infections . |