This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yang, K. H. Articles by Byun, Y. S. Search for Related Content PubMed PubMed Citation Articles by Yang, K. H. Articles by Byun, Y. S.

Separate vertical wiring for the fixation of comminuted fractures of the inferior pole of the patella

Department of Orthopaedic Surgery, Youngdong Severance Hospital, 146-92, Dokokdong, Kangnamku, Seoul, Korea.

Y. S. Byun, MD, Chairman

Department of Orthopaedic Surgery, Daegu Fatima Hospital, 302-1, Shinamdong dongku, Daegu, Korea.

Correspondence should be sent to Professor K. H. Yang.

Comminuted and displaced fractures of the inferior pole of the patella are not easy to reduce and it is difficult to fix the fragments soundly enough to allow early movement of the knee. We have evaluated the clinical effectiveness of the separate vertical wiring technique in acute comminuted fractures of the inferior pole of the patella. A biomechanical study was also performed using ten pairs of embalmed cadaver knees. A four-part fracture was made on the inferior pole of the patella and fixed by two separate vertical wires on one side and two pull-out sutures after partial patellectomy on the other.

The ultimate load to failure in the first group was significantly higher than in the second (250.1± 109.7 N v 69.7 ± 18.9 N, p<0.002), as was the stiffness (279.9 ± 76.4 N/mm v 23.2 ± 11.4 N/mm, p<0.001).

The separate wire technique was used in 25 patients with comminuted fractures of the inferior pole of the patella who were followed up for a mean period of 22 months (10 to 50). All the fractures healed at a mean of seven weeks (6 to 10). No breakage of a wire or infection occurred. The mean grading at the final follow-up was 29.5 points (27 to 30) using the Böstman method. This technique preserved the length of the patella, fixed the comminuted fragments of the inferior pole and avoided long-term immobilisation of the knee.