Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing

• Published in: Injury Vol. 46; no. 12; pp. 2512 - 2515
• Main Authors: Oh, Hyoung-Keun, Choo, Suk-Kyu, Kim, Ji-Wan, Lee, Mark
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2015
• Subjects: Adult; Aged; Bone Wires; Female; Fracture Fixation, Internal - methods; Fracture Healing; Fractures, Bone - diagnostic imaging; Fractures, Bone - physiopathology; Fractures, Bone - surgery; Fractures, Comminuted - diagnostic imaging; Fractures, Comminuted - physiopathology; Fractures, Comminuted - surgery; Humans; Knee Joint - physiopathology; Knee Joint - surgery; Krackow suture; Male; Middle Aged; Orthopedics; Patella - diagnostic imaging; Patella - injuries; Patella - surgery; Patellar fracture; Practice Guidelines as Topic; Range of Motion, Articular; Retrospective Studies; Separate vertical wiring; Sutures; Treatment Outcome; Patellar fracture; Krackow suture; Separate vertical wiring
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2015.09.026

Abstract Background We present the surgical technique of separate vertical wiring for displaced inferior pole fractures of the patella combined with Krachow suture and report the surgical outcomes. Materials and methods Between September 2007 to May 2012, 11 consecutive patients (mean age, 54.6 years) with inferior pole fractures of the patella (AO/OTA 34-A1) were retrospectively enrolled in this study. Through longitudinal incision, all patients underwent open reduction and internal fixation by separate vertical wiring combined with Krackow suture. The range of motion, loss of fixation, and Bostman score were primary outcome measures. Results The union time was 10 weeks after surgery on average (range: 8–12). No patient had nonunion, loss of reduction and wire breakage. There was no case of wound problem and irritation from the implant. At final follow-up, the average range of motion arc was 129.4° (range: 120–140). The mean Bostman score at last follow-up was 29.6 points (range: 28–30) and graded excellent in all cases. Conclusion Separate vertical wiring combined with Krackow suture for inferior pole fractures of the patella is a useful technique that is easy to perform and can provide stable fixation with excellent results in knee function.