A Novel Technique for the
Treatment of Patellar Distal Pole Fracture: A Observational Study
Mohammad Shah Kamal Uddin1*, Tutul Talukder2, Muhammad Amzad Hussain3, Ushahla Marma4, AKM Harun-Ar-Rashid5, Mohammad Ridowan Tareen6 and Md Ayub Ali7
1Senior Consultant of Orthopaedic Surgery, 250 Bed District Sadar Hospital, Cox’s Bazar, Bangladesh
2Junior Consultant of Surgery, 250 Bed District Sadar Hospital, Cox’s Bazar, Bangladesh
3Junior Consultant of Orthopaedic Surgery, Moheshkhali Upazila Health Complex, Cox’s Bazar, Bangladesh
4Assistant Registrar of Orthopaedic Surgery, 250 Bed District Sadar Hospital, Cox’s Bazar, Bangladesh
5Assistant Professor of Orthopaedic Surgery, Cox's Bazar Medical College, Cox’s Bazar, Bangladesh
6Resident Surgeon of General Surgery, 250 Bed District Sadar Hospital, Cox’s Bazar, Bangladesh
7Associate Professor of Orthopaedic Surgery, Cox's Bazar Medical College, Cox’s Bazar, Bangladesh
*Corresponding Author: Mohammad Shah Kamal Uddin, Senior Consultant of Orthopaedic Surgery, 250 Bed District Sadar Hospital, Cox’s Bazar, Bangladesh.
June 14, 2023; Published: July 14, 2023
Background: The patella is a triangle sesamoid bone located on the anterior part of the knee at the distal portion of the femur. Its principal function is to act as a fulcrum to enhance the moment arm of the quadriceps muscle and thus knee extensive capabilities.
Objective: This study was conducted to evaluate a clinical and functional usefulness of Separate Vertical Wirings for the treatment of Extra-Articular Fractures of the Distal Pole of Patella at National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) from July 2015 to June 2017.
Methods: The study included 40 patients with closed extra-articular fracture of the distal pole of the patella aged 18-70 years, regardless of gender. Patients with pathological fracture, multiple injuries and inability to walk before the fracture were excluded from the study.
Results: They were evaluated by Bostman knee score (ROM, pain, work, atrophy, assistance in walking, effusion, giving way, stair climbing). At final follow-up 31 (77.5%) patients had full extension and ROM 120 degree and 9 (22.5%) patients had ROM 90-120 degree. The main complications was knee stiffness which was 30%. Almost 95% patients had no pain and returned to their original job after 18 weeks of fixation with no significant limitations. The fractures united at a mean of 8 weeks (6 to 10) and no case of non- union was observed. Evaluation of outcome 18 weeks after fixation showed that 60% of the patients had excellent outcome (Bostman Score 28-30) and 40% had good outcome (Bostman Score 20-27).
Conclusion: The majority of patients with extra-articular distal pole patella fractures are farmers in early middle age. For extra-articular patella distal pole fractures, vertical wiring works well. Most patients have resumed pre-injury activities with minor knee restrictions. Larger trials are needed because this study's sample size may skew clinical efficacy assessments.
Keywords: Extra-Articular Patella Distal Pole Fractures; Vertical Wiring; Unilateral IPFP Diagnosed by Imaging
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