Surgical Treatment of Comminuted Interior Patellar Pole Fractures by Separate Vertical Wirings: A New Method of Internal Fixation

Byun, Young Soo; Kim, Hong Tae; Yoo, Chan Hoon; Kim, Hyun MiH; Park, Yeon Min; Shin, Sang Chul

Abstract

The inferior pole fragments of patellar fractures should be reduced anatomically whenever possible because any resection of the inferior pole fragments results in patella baja and abnormal patellofemoral biomechanics. However, there are still no effective methods of stable fixation for comminuted inferior patellar pole fractures. The purpose of this study is to introduce a new method of internal fixation of separate vertical wirings for comminuted inferior patellar pole fractures and to present the results of the wirings. Thirteen patients with comminuted inferior patellar pole fracture were treated with 2 to 4 separate vertical wirings, which provided the sufficient strength to allow early motion without loss of reduction during fracture healing. All the fractures were healed in anatomical position and all the patients regained full range of motion of the knee. Loss of fixation occurred in a patient by foiling on the ground, but the fracture was healed by the wirings again. There were no patients with radiographic evidence of posttraumatic osteoarthritis at the final follow-up. Overall result was rated as excellent in all the patients. The results of this study indicate that separate vertical wirings are an effective method of stable fixation enough to allow early motion without loss of reduction during fracture healing for comminuted inferior patellar pole fractures.