Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique
Purpose Comminuted inferior pole fractures of the patella are notorious fractures where it is difficult to obtain rigid internal fixation by conventional tension band wiring. The purpose of this study is to evaluate the clinical and radiological outcomes of the suture bridge anchor fixation for thes...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2021-11, Vol.141 (11), p.1889-1897 |
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| creator | Kim, Kwang-Sub Suh, Dong-Whan Park, Sang-Eun Ji, Jong-Hun Han, Young-Hoon Kim, Jae-Hoon |
| description | Purpose
Comminuted inferior pole fractures of the patella are notorious fractures where it is difficult to obtain rigid internal fixation by conventional tension band wiring. The purpose of this study is to evaluate the clinical and radiological outcomes of the suture bridge anchor fixation for these comminuted inferior pole fractures of the patella.
Methods
From March 2012 to December 2018, suture bridge anchor fixation for the inferior pole comminuted fracture of the patella was performed in 22 patients. There were 21 patients of inferior pole comminuted fracture and 1 patient of lower periosteal sleeve avulsion fracture. Clinical outcomes including SF-36 score, Knee injury and osteoarthritis outcome score (KOOS) and post-operative range of motion were evaluated. In all patients, suture bridge anchor fixation was performed and, tension band wiring with K wire was added for large fragment fixation in two patients. We evaluated bony union, the patellar height using Insall–Salvati ratio and its complications.
Results
Mean age was 46 ± 20 (15–82) years. Mean follow-up period was 25 ± 18 (11–74) months. In all patients, bony union was achieved at postoperative 4 months. At final follow-up, mean SF-36 score was 72 ± 15 (30–91) points and KOOS score was 66.7 ± 16 (43–97). The average range of motion was 134 ± 5 (125–140) degrees. As a complication, one patient developed a wound infection and subsequent osteomyelitis of inferior pole fracture fragment. Compared to the normal knee, the Insall–Salvati ratio of the injured knee averages 0.73 and this smaller ratio less than 0.8 meant patella baja.
Conclusions
In the comminuted inferior pole fractures of the patella, suture bridge anchor fixation showed good bony union and satisfactory clinical outcomes at the short-term follow-up and could be a satisfactory alternative treatment option. Even though suture bridge anchor fixation in these fractures caused decreased Insall–Salvati ratio (patella height), any patellofemoral pain and limited range of motion was not developed.
Level of evidence
Level IV |
| doi_str_mv | 10.1007/s00402-020-03671-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2456413107</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2456413107</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-4b9e5f6d07280af998cd437d17c1558d1430a53d869672900d985625bcbe63923</originalsourceid><addsrcrecordid>eNp9kU9LHTEUxUNR6Kv6BVwFuukm9SaZJBN3RfpHEFyo65DJZN6LzEueyUyp4Ic3ryMVKri6i_s7597DQeiUwlcKoM4KQAOMAAMCXCpKxAe0og1vCNdUHqAVaC5JC4J-RJ9KuQegrNWwQk838zRnj210m5TxEP7YKaSI04Bd2m5DnCff4xAHn0Pd79Lo8c5OfhwtHrJ1ezGJ6bcf8eTdJoaH2Z_jsph2OfTrt97_wGN0ONix-JOXeYTufny_vfhFrq5_Xl58uyKOCzaRptNeDLIHxVqwg9at6xuueqocFaLta06wgvet1FIxDdDrVkgmOtd5yTXjR-jL4rvLqZ4tk9mG4vYZok9zMawRsqGcgqro5__Q-zTnWL8zTCjdKsYErxRbKJdTKdkPZpfD1uZHQ8HsCzFLIaYWYv4WYkQV8UVUKhzXPr9av6N6BgXRjyg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2579872253</pqid></control><display><type>article</type><title>Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique</title><source>SpringerLink Journals - AutoHoldings</source><creator>Kim, Kwang-Sub ; Suh, Dong-Whan ; Park, Sang-Eun ; Ji, Jong-Hun ; Han, Young-Hoon ; Kim, Jae-Hoon</creator><creatorcontrib>Kim, Kwang-Sub ; Suh, Dong-Whan ; Park, Sang-Eun ; Ji, Jong-Hun ; Han, Young-Hoon ; Kim, Jae-Hoon</creatorcontrib><description>Purpose
Comminuted inferior pole fractures of the patella are notorious fractures where it is difficult to obtain rigid internal fixation by conventional tension band wiring. The purpose of this study is to evaluate the clinical and radiological outcomes of the suture bridge anchor fixation for these comminuted inferior pole fractures of the patella.
Methods
From March 2012 to December 2018, suture bridge anchor fixation for the inferior pole comminuted fracture of the patella was performed in 22 patients. There were 21 patients of inferior pole comminuted fracture and 1 patient of lower periosteal sleeve avulsion fracture. Clinical outcomes including SF-36 score, Knee injury and osteoarthritis outcome score (KOOS) and post-operative range of motion were evaluated. In all patients, suture bridge anchor fixation was performed and, tension band wiring with K wire was added for large fragment fixation in two patients. We evaluated bony union, the patellar height using Insall–Salvati ratio and its complications.
Results
Mean age was 46 ± 20 (15–82) years. Mean follow-up period was 25 ± 18 (11–74) months. In all patients, bony union was achieved at postoperative 4 months. At final follow-up, mean SF-36 score was 72 ± 15 (30–91) points and KOOS score was 66.7 ± 16 (43–97). The average range of motion was 134 ± 5 (125–140) degrees. As a complication, one patient developed a wound infection and subsequent osteomyelitis of inferior pole fracture fragment. Compared to the normal knee, the Insall–Salvati ratio of the injured knee averages 0.73 and this smaller ratio less than 0.8 meant patella baja.
Conclusions
In the comminuted inferior pole fractures of the patella, suture bridge anchor fixation showed good bony union and satisfactory clinical outcomes at the short-term follow-up and could be a satisfactory alternative treatment option. Even though suture bridge anchor fixation in these fractures caused decreased Insall–Salvati ratio (patella height), any patellofemoral pain and limited range of motion was not developed.
Level of evidence
Level IV</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-020-03671-5</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Knee ; Medicine ; Medicine & Public Health ; Orthopedics ; Patients ; Range of motion ; Surgical outcomes ; Surgical techniques ; Trauma Surgery</subject><ispartof>Archives of orthopaedic and trauma surgery, 2021-11, Vol.141 (11), p.1889-1897</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-4b9e5f6d07280af998cd437d17c1558d1430a53d869672900d985625bcbe63923</citedby><cites>FETCH-LOGICAL-c352t-4b9e5f6d07280af998cd437d17c1558d1430a53d869672900d985625bcbe63923</cites><orcidid>0000-0003-1087-3254</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-020-03671-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-020-03671-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Kim, Kwang-Sub</creatorcontrib><creatorcontrib>Suh, Dong-Whan</creatorcontrib><creatorcontrib>Park, Sang-Eun</creatorcontrib><creatorcontrib>Ji, Jong-Hun</creatorcontrib><creatorcontrib>Han, Young-Hoon</creatorcontrib><creatorcontrib>Kim, Jae-Hoon</creatorcontrib><title>Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><description>Purpose
Comminuted inferior pole fractures of the patella are notorious fractures where it is difficult to obtain rigid internal fixation by conventional tension band wiring. The purpose of this study is to evaluate the clinical and radiological outcomes of the suture bridge anchor fixation for these comminuted inferior pole fractures of the patella.
Methods
From March 2012 to December 2018, suture bridge anchor fixation for the inferior pole comminuted fracture of the patella was performed in 22 patients. There were 21 patients of inferior pole comminuted fracture and 1 patient of lower periosteal sleeve avulsion fracture. Clinical outcomes including SF-36 score, Knee injury and osteoarthritis outcome score (KOOS) and post-operative range of motion were evaluated. In all patients, suture bridge anchor fixation was performed and, tension band wiring with K wire was added for large fragment fixation in two patients. We evaluated bony union, the patellar height using Insall–Salvati ratio and its complications.
Results
Mean age was 46 ± 20 (15–82) years. Mean follow-up period was 25 ± 18 (11–74) months. In all patients, bony union was achieved at postoperative 4 months. At final follow-up, mean SF-36 score was 72 ± 15 (30–91) points and KOOS score was 66.7 ± 16 (43–97). The average range of motion was 134 ± 5 (125–140) degrees. As a complication, one patient developed a wound infection and subsequent osteomyelitis of inferior pole fracture fragment. Compared to the normal knee, the Insall–Salvati ratio of the injured knee averages 0.73 and this smaller ratio less than 0.8 meant patella baja.
Conclusions
In the comminuted inferior pole fractures of the patella, suture bridge anchor fixation showed good bony union and satisfactory clinical outcomes at the short-term follow-up and could be a satisfactory alternative treatment option. Even though suture bridge anchor fixation in these fractures caused decreased Insall–Salvati ratio (patella height), any patellofemoral pain and limited range of motion was not developed.
Level of evidence
Level IV</description><subject>Knee</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Range of motion</subject><subject>Surgical outcomes</subject><subject>Surgical techniques</subject><subject>Trauma Surgery</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU9LHTEUxUNR6Kv6BVwFuukm9SaZJBN3RfpHEFyo65DJZN6LzEueyUyp4Ic3ryMVKri6i_s7597DQeiUwlcKoM4KQAOMAAMCXCpKxAe0og1vCNdUHqAVaC5JC4J-RJ9KuQegrNWwQk838zRnj210m5TxEP7YKaSI04Bd2m5DnCff4xAHn0Pd79Lo8c5OfhwtHrJ1ezGJ6bcf8eTdJoaH2Z_jsph2OfTrt97_wGN0ONix-JOXeYTufny_vfhFrq5_Xl58uyKOCzaRptNeDLIHxVqwg9at6xuueqocFaLta06wgvet1FIxDdDrVkgmOtd5yTXjR-jL4rvLqZ4tk9mG4vYZok9zMawRsqGcgqro5__Q-zTnWL8zTCjdKsYErxRbKJdTKdkPZpfD1uZHQ8HsCzFLIaYWYv4WYkQV8UVUKhzXPr9av6N6BgXRjyg</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Kim, Kwang-Sub</creator><creator>Suh, Dong-Whan</creator><creator>Park, Sang-Eun</creator><creator>Ji, Jong-Hun</creator><creator>Han, Young-Hoon</creator><creator>Kim, Jae-Hoon</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1087-3254</orcidid></search><sort><creationdate>20211101</creationdate><title>Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique</title><author>Kim, Kwang-Sub ; Suh, Dong-Whan ; Park, Sang-Eun ; Ji, Jong-Hun ; Han, Young-Hoon ; Kim, Jae-Hoon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-4b9e5f6d07280af998cd437d17c1558d1430a53d869672900d985625bcbe63923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Knee</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Range of motion</topic><topic>Surgical outcomes</topic><topic>Surgical techniques</topic><topic>Trauma Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Kwang-Sub</creatorcontrib><creatorcontrib>Suh, Dong-Whan</creatorcontrib><creatorcontrib>Park, Sang-Eun</creatorcontrib><creatorcontrib>Ji, Jong-Hun</creatorcontrib><creatorcontrib>Han, Young-Hoon</creatorcontrib><creatorcontrib>Kim, Jae-Hoon</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Kwang-Sub</au><au>Suh, Dong-Whan</au><au>Park, Sang-Eun</au><au>Ji, Jong-Hun</au><au>Han, Young-Hoon</au><au>Kim, Jae-Hoon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><date>2021-11-01</date><risdate>2021</risdate><volume>141</volume><issue>11</issue><spage>1889</spage><epage>1897</epage><pages>1889-1897</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Purpose
Comminuted inferior pole fractures of the patella are notorious fractures where it is difficult to obtain rigid internal fixation by conventional tension band wiring. The purpose of this study is to evaluate the clinical and radiological outcomes of the suture bridge anchor fixation for these comminuted inferior pole fractures of the patella.
Methods
From March 2012 to December 2018, suture bridge anchor fixation for the inferior pole comminuted fracture of the patella was performed in 22 patients. There were 21 patients of inferior pole comminuted fracture and 1 patient of lower periosteal sleeve avulsion fracture. Clinical outcomes including SF-36 score, Knee injury and osteoarthritis outcome score (KOOS) and post-operative range of motion were evaluated. In all patients, suture bridge anchor fixation was performed and, tension band wiring with K wire was added for large fragment fixation in two patients. We evaluated bony union, the patellar height using Insall–Salvati ratio and its complications.
Results
Mean age was 46 ± 20 (15–82) years. Mean follow-up period was 25 ± 18 (11–74) months. In all patients, bony union was achieved at postoperative 4 months. At final follow-up, mean SF-36 score was 72 ± 15 (30–91) points and KOOS score was 66.7 ± 16 (43–97). The average range of motion was 134 ± 5 (125–140) degrees. As a complication, one patient developed a wound infection and subsequent osteomyelitis of inferior pole fracture fragment. Compared to the normal knee, the Insall–Salvati ratio of the injured knee averages 0.73 and this smaller ratio less than 0.8 meant patella baja.
Conclusions
In the comminuted inferior pole fractures of the patella, suture bridge anchor fixation showed good bony union and satisfactory clinical outcomes at the short-term follow-up and could be a satisfactory alternative treatment option. Even though suture bridge anchor fixation in these fractures caused decreased Insall–Salvati ratio (patella height), any patellofemoral pain and limited range of motion was not developed.
Level of evidence
Level IV</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00402-020-03671-5</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1087-3254</orcidid></addata></record> |
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| ispartof | Archives of orthopaedic and trauma surgery, 2021-11, Vol.141 (11), p.1889-1897 |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Knee Medicine Medicine & Public Health Orthopedics Patients Range of motion Surgical outcomes Surgical techniques Trauma Surgery |
| title | Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique |
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