مرکز منطقه ای اطلاع رساني علوم و فناوري - Fractured patella in children: Preservation of the patellar dimensions

Abstract :

Objectives: The progressive understanding of the mechanical function of the patella makes preservation of its geometry is mandatory, particularly during its reconstruction. Objectives of this study were to compare the patellar dimensions after surgical and conservative treatment for patellar fractures in children and to present influence of the changes in the patellar dimensions on the knee motions. Materials and methods: Two groups of children with patellar fractures their ages at time of injury averaged 12 years. One group included five children, was treated surgically using of the inter-fragmentary wiring technique and the other group that includes seven children was treated conservatively. Patients were prospectively followed for a period-averaged 65.5 months, the knee function and the patellar dimensions were assessed clinically and radiographically. Results: The group was treated surgically reported insignificant increase in the patellar longitudinal length and reported no extension lag; however, reported average 9° flexion deficit, which is possibly correlated to radiographic increase of the patellar thickness. The group was treated conservatively reported significant increase in the patellar longitudinal length and reported extension lag averaged 4.3° and flexion deficit averaged 7.14°. Conclusions: Surgical treatment preserved to great extent the longitudinal patellar length but it failed to preserve the patellar thickness particularly in the comminuted patellar fractures. The patellar elongation caused extension lag and flexion deficit while the mere increase of the patellar thickness produced flexion deficit without extension lag.