Surgical treatment of comminuted patella fractures with a percutaneous minimally invasive Pyrford technique

ZHOU Kai-hua; YANG Jun

doi:10.3969/j.issn.2095-252X.2017.11.006

Abstract：Objective To evaluate clinical outcomes and operation indications of percutaneous minimally invasive Pyrford technique for comminuted patella fractures. Methods From February 2008 to June 2013, 28 patients with comminuted patellar fractures were included in this study. Healing time, visual analogue scales ( VAS ), joint range of motion, Bostman score were evaluated. Results All patients were followed up for a mean period of 34.4 months ( range: 13 - 53 months ). The mean operation time was ( 72.3 ± 31.9 ) minutes. The mean intraoperative fluoroscopy was ( 7.6 ± 2.4 ) times. Radiographic evidence of solid fracture union was observed in all cases in a mean time period of ( 13.7 ± 2.6 ) weeks. The VAS score for pain was ( 3.4 ± 1.0 ) at 4 weeks after the surgery, and ( 1.2 ± 1.0 ) when radiographic fracture got healed. At the latest follow-up, the range of motion was on average ( 139.8 ± 5.4 ) °. The average Bostman Score was ( 28.8 ± 1.0 ) at 1 year after the surgery. An evaluation of "excellent" was given to 26 patients at the final follow-up. We had 1 case with steel wire broken and 1 case with K-wire out slightly, but the fractures had already been united. There were no other complications, such as displacement, wound infection or non-union. Conclusions Surgical treatment of comminuted patellar fractures by the percutaneous pyrford technique can provide satisfactory clinical results and knee functions, with advantages of small incision, simple operation, anatomical reduction, stable fixation and early mobilisation.