inferior patellar pole avulsion fractures: osteosynthesis compared with pole resection by matjaz...

Inferior Patellar Pole Avulsion Fractures: Osteosynthesis Compared with Pole Resection

by Matjaz Veselko, and Matej Kastelec

JBJS Essent Surg TechVolume os-87(1 suppl 1):113-121

March 1, 2005

©2005 by The Journal of Bone and Joint Surgery, Inc.

Preoperative radiograph showing an avulsion fracture of the patellar pole.

Matjaz Veselko, and Matej Kastelec J Bone Joint Surg Am 2005;os-87:113-121


The patient is placed in the supine position.



The straight midline skin incision starts approximately two fingerbreadths proximal to the displaced proximal fragment of the patella and runs distally to the tibial tuberosity.



The ruptured retinaculum on either side of the fracture, both fragments, and the patellar tendon are exposed.



Intraoperative photograph demonstrating placement of the interwoven suture.



The four posterior hooks of the basket plate are thrust through the patellar tendon, just distal to the suture line, so that the fragments are embraced by the basket.



A 2.0-mm Kirschner wire is drilled through one of the central plate holes and through the patellar pole as posteriorly as possible.



The pole fragments within the plate are reduced and fixed with two large, pointed reduction forceps to the main fragment, and the Kirschner wire is drilled across the fracture into the

proximal fragment.



One of the large, pointed reduction forceps, previously repositioned around the apex of the plate, compresses the plate and the pole fragments against the main fragment.



Fluoroscopic image showing the final position of the basket plate after fixation to the main fragment with four screws.



Intraoperative photograph showing the final position of the basket plate after coverage with soft tissue.



The stability of fixation is checked by flexing the knee into full flexion before the wound is closed.



Postoperative lateral radiograph demonstrating anatomic reduction of the fracture and a reduced position of the patella.



inferior patellar pole avulsion fractures: osteosynthesis compared with pole resection by matjaz...

Documents

joint surgery

journal of bone

pole fragments

basket plate

patellar tendon

main fragment

displaced proximal fragment

central plate holes