RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0042-1750695
Use of Mesh Plate for the Treatment of Comminuted Patellar Fractures: Case Report
Artikel in mehreren Sprachen: español | English Funding The authors declare that the present study did not receive any type of institutional or private funding.![](https://www.thieme-connect.de/media/10.1055-s-00033425/202203/lookinside/thumbnails/10-1055-s-0042-1750695_2100024_en-1.jpg)
Abstract
Objective To describe the surgical technique for the use of a mesh plate in a case of comminuted patellar fracture and the mid-term follow up outcomes.
Materials and Methods We present a case of comminuted patella fracture managed with the use of a mesh plate and an associated cannulated screw, thus avoiding partial patellectomy and its possible complications.
Results Four months postoperatively, the patient presented full knee range of motion and could be discharged to return to work, with no complications or reinterventions.
Discussion The use of mesh plates enables the management of comminuted patellar fractures preserving bone stock and restoring the extensor mechanism with a stable and little prominent osteosynthesis. Cases which previously would only have been treated by partial patellectomy and patellar tendon reinsertion can be treated with these plates.
Conclusion The use of mesh plates for comminuted patellar fractures is an attractive option due to their stability, their ability to preserve bone stock, and the low rates of reintervention.
Level of evidence V.
Publikationsverlauf
Eingereicht: 09. August 2021
Angenommen: 17. Mai 2022
Artikel online veröffentlicht:
28. Dezember 2022
© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
Referencias
- 1 Melvin JS, Mehta S. Patellar fractures in adults. J Am Acad Orthop Surg 2011; 19 (04) 198-207
- 2 Tornetta P. Rockwood and Green's fractures in adults [Internet]. 2020 [citado 23 de junio de 2021]. Disponible en: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=booktext&D=books3&AN=02112923/9th_Edition
- 3 Larsen P, Court-Brown CM, Vedel JO, Vistrup S, Elsoe R. Incidence and Epidemiology of Patellar Fractures. Orthopedics 2016; 39 (06) e1154-e1158
- 4 Böstman O, Kiviluoto O, Nirhamo J. Comminuted displaced fractures of the patella. Injury 1981; 13 (03) 196-202
- 5 Moore TB, Sampathi BR, Zamorano DP, Tynan MC, Scolaro JA. Fixed angle plate fixation of comminuted patellar fractures. Injury 2018; 49 (06) 1203-1207
- 6 Macausland WR. Total patellectomy: report of twenty-eight cases. Am J Surg 1953; 87 (02) 221-226
- 7 Khermosh O, Weissman SL. Total patellectomy in fractures of the patella. Isr J Med Sci 1973; 9 (01) 67-70
- 8 Pandey AK, Pandey S, Pandey P. Results of partial patellectomy. Arch Orthop Trauma Surg 1991; 110 (05) 246-249
- 9 Saltzman CL, Goulet JA, McClellan RT, Schneider LA, Matthews LS. Results of treatment of displaced patellar fractures by partial patellectomy. J Bone Joint Surg Am 1990; 72 (09) 1279-1285
- 10 Carpenter J, Kasman R, Matthews L. Fractures of the Patella. J Bone Joint Surg 1993; 75 (10) 1550-1561
- 11 Sutton Jr FS, Thompson CH, Lipke J, Kettelkamp DB. The effect of patellectomy on knee function. J Bone Joint Surg Am 1976; 58 (04) 537-540
- 12 Boström A. Fracture of the patella. A study of 422 patellar fractures. Acta Orthop Scand Suppl 1972; 143: 1-80
- 13 Lee B-J, Chon J, Yoon J-Y, Jung D. Modified Tension Band Wiring Using FiberWire for Patellar Fractures. Clin Orthop Surg 2019; 11 (02) 244-248
- 14 Agarwala S, Agrawal P, Sobti A. A novel technique of patella fracture fixation facilitating early mobilization and reducing re-operation rates. J Clin Orthop Trauma 2015; 6 (03) 207-211
- 15 Yang L, Yueping O, Wen Y. Management of displaced comminuted patellar fracture with titanium cable cerclage. Knee 2010; 17 (04) 283-286
- 16 Sun Y, Sheng K, Li Q, Wang D, Zhou D. Management of comminuted patellar fracture fixation using modified cerclage wiring. J Orthop Surg Res 2019; 14 (01) 324-331
- 17 Chen M, Jin X, Fryhofer GW. et al. The application of the Nice knots as an auxiliary reduction technique in displaced comminuted patellar fractures. Injury 2020; 51 (02) 466-472
- 18 Zhai Q, Yang J, Zhuang J, Gao R, Chen M. Percutaneous cerclage wiring for type 34-C patella fracture in geriatric patients. Injury 2020; 51 (06) 1362-1366
- 19 Lue TH, Feng LW, Jun WM, Yin LW. Management of comminuted patellar fracture with non-absorbable suture cerclage and Nitinol patellar concentrator. Injury 2014; 45 (12) 1974-1979
- 20 Zhao QM, Yang HL, Wang L, Liu ZT, Gu XF. Treatment of comminuted patellar fracture with the nitinol patellar concentrator. Minim Invasive Ther Allied Technol 2016; 25 (03) 171-175
- 21 Yao C, Sun J, Wu J. et al. Clinical outcomes of Ti-Ni shape-memory patella concentrator combined with cannulated compression screws in the treatment of C2 and C3 patella fracture: a retrospective study of 54 cases. BMC Musculoskelet Disord 2020; 21 (01) 506-513
- 22 Wild M, Fischer K, Hilsenbeck F, Hakimi M, Betsch M. Treating patella fractures with a fixed-angle patella plate-A prospective observational study. Injury 2016; 47 (08) 1737-1743
- 23 Ellwein A, Lill H, Jensen G, Gruner A, Katthagen JC. Plate osteosynthesis after patellar fracture – the technique and initial results of a prospective study. Unfallchirurg 2017; 120 (09) 753-760
- 24 Wurm S, Bühren V, Augat P. Treating patella fractures with a locking patella plate - first clinical results. Injury 2018; 49 (Suppl. 01) S51-S55
- 25 Cho J-W, Kent WT, Cho W-T. et al. Miniplate Augmented Tension-Band Wiring for Comminuted Patella Fractures. J Orthop Trauma 2019; 33 (04) e143-e150
- 26 Blum L, Hake M. ORIF Patella Fracture With a Tension Band Construct. J Orthop Trauma 2017; 31 (Suppl. 03) S8-S9
- 27 Tan H, Dai P, Yuan Y. Clinical results of treatment using a modified K-wire tension band versus a cannulated screw tension band in transverse patella fractures: A strobe-compliant retrospective observational study. Medicine (Baltimore) 2016; 95 (40) e4992
- 28 Vajapey S, Santiago J, Contreras E, Quatman CE, Phieffer LS. Contourable craniofacial mesh plate osteosynthesis of patellar fractures: A new, low-profile fixation technique. J Clin Orthop Trauma 2019; 10 (Suppl. 01) S201-S206
- 29 Rajagopalakrishnan R, Soraganvi P, Douraiswami B, Velmurugesan P, Muthukumar S. “Is articular cartilage reconstruction feasible in OTA-C2, C3 comminuted patellar fractures?”. A prospective study of methodical reduction and fixation Journal Arthrosc Joint Surg 2016; 3 (02) 66-70
- 30 Thelen S, Betsch M, Schneppendahl J. et al. Fixation of multifragmentary patella fractures using a bilateral fixed-angle plate. Orthopedics 2013; 36 (11) e1437-e1443
- 31 Wagner FC, Neumann MV, Wolf S. et al. Biomechanical comparison of a 3.5 mm anterior locking plate to cannulated screws with anterior tension band wiring in comminuted patellar fractures. Injury 2020; 51 (06) 1281-1287
- 32 Müller EC, Frosch K-H. Plattenosteosynthese bei Patellafrakturen. Oper Orthop Traumatol 2017; 29 (06) 509-519
- 33 Matejčić A, Ivica M, Jurišić D, Ćuti T, Bakota B, Vidović D. Internal fixation of patellar apex fractures with the basket plate: 25 years of experience. Injury 2015; 46 (Suppl. 06) S87-S90
- 34 Dickens AJ, Salas C, Rise L. et al. Titanium mesh as a low-profile alternative for tension-band augmentation in patella fracture fixation: A biomechanical study. Injury 2015; 46 (06) 1001-1006
- 35 Volgas D, Dreger TK. The Use of Mesh Plates for Difficult Fractures of the Patella. J Knee Surg 2017; 30 (03) 200-203
- 36 Singer MS, Halawa AM, Adawy A. Outcome of low profile mesh plate in management of comminuted displaced fracture patella. Injury 2017; 48 (06) 1229-1235
- 37 Siljander M, Vara AD, Koueiter DM. et al. Plate Osteosynthesis of Patella Fractures-A Video Case Report. J Orthop Trauma 2017; 31 (Suppl. 03) S26-S27
- 38 Siljander M, Koueiter DM, Gandhi S, Wiater BP, Wiater PJ. Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures. J Knee Surg 2018; 31 (09) 919-926
- 39 Lorich DG, Warner SJ, Schottel PC, Shaffer AD, Lazaro LE, Helfet DL. Multiplanar Fixation for Patella Fractures Using a Low-Profile Mesh Plate. J Orthop Trauma 2015; 29 (12) e504-e510
- 40 Wurm S, Augat P, Bühren V. Biomechanical Assessment of Locked Plating for the Fixation of Patella Fractures. J Orthop Trauma 2015; 29 (09) e305-e308
- 41 Thelen S, Schneppendahl J, Jopen E. et al. Biomechanical cadaver testing of a fixed-angle plate in comparison to tension wiring and screw fixation in transverse patella fractures. Injury 2012; 43 (08) 1290-1295
- 42 Wild M, Eichler C, Thelen S, Jungbluth P, Windolf J, Hakimi M. Fixed-angle plate osteosynthesis of the patella - an alternative to tension wiring?. Clin Biomech (Bristol, Avon) 2010; 25 (04) 341-347
- 43 Yoon Y-C, Sim J-A, Hong J-H. Surgery of patellar fractures using a medial parapatellar approach. J Orthop Surg (Hong Kong) 2017; 25 (02) 2309499017719378
- 44 Hoshino CM, Tran W, Tiberi JV. et al. Complications following tension-band fixation of patellar fractures with cannulated screws compared with Kirschner wires. J Bone Joint Surg Am 2013; 95 (07) 653-659
- 45 Lazaro LE, Wellman DS, Sauro G. et al. Outcomes after operative fixation of complete articular patellar fractures: assessment of functional impairment. J Bone Joint Surg Am 2013; 95 (14) e96 , 1–8