Prakash Ponnan1, Manoj Murungodiyil Kunjappan2
BACKGROUND
Patella is the largest sesamoid bone in the human body, which plays important
role in biomechanics of the knee. It is one of the few bones without periosteal
surrounding. Fracture of patella constitute almost 1 % of all skeletal injuries with
high prevalence in age group of 20 - 50 years. Fracture of patella may be due to
direct/indirect force. Direct force often results in displaced or comminuted
fractures. Fracture caused by indirect mechanisms result from a violent contraction
of quadriceps muscle with knee flexion. Most of the patella fractures are
combination of direct and indirect forces. Most significant effects of fracture patella
are loss of continuity of the extensor mechanism of the knee and potential
incongruity of the patellofemoral articulation. Treatment option includes
reconstruction of entire patella or partial patellectomy and tendon repair or total
patellectomy with extensor mechanism repair. Advancement in surgical techniques
treatment option being shifted from patellectomy to reconstruction, preservation,
and restoration of extensor mechanism. The purpose of this study was to evaluate
the functional outcome of transverse fracture of patella treated with tension band
wiring.
METHODS
This prospective study was done among 35 patients, who sustained transverse
patellar fractures and were admitted in Department of Orthopaedics, Government
Medical College, Thrissur from 01 October 2019 to 01 October 2020. Functional
and clinical outcome was assessed at 2 weeks, 4 weeks, 3 months, and 6 months
using Goodfellow’s scoring system.
RESULTS
The mean age was found to be 43 years, males were predominant. In 62.86 % of
study population, right side was involved. In 63 % of study population, fracture
occurred due to road traffic accidents (RTA). Average union was achieved in 11 -
13 weeks. Functional outcome was excellent to good in 85.71 % of study
population.
CONCLUSIONS
Transverse fracture of patella can be treated with modified tension band wiring
without much complications and early weight bearing is possible with good
functional outcome.
