A Novel Percutaneous Fixation Technique of Patella Fractures with Unique Advantages

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Abstract
Objectives: The patella, a sesamoid bone within the quadriceps tendon, enhances knee extension. Patellar fractures, often from direct or indirect trauma, disrupt the extensor mechanism. Diagnosis involves clinical examination and imaging. Treatment options include non-surgical, minimally invasive percutaneous fixation (MIPF) and open reduction internal fixation (ORIF), each with specific indications and potential complications. This investigation seeks to develop and evaluate a novel percutaneous fixation technique employing FiberWire for the management of transverse patellar fractures. The proposed method aims to mitigate the limitations inherent to both open and minimally invasive surgical approaches. Material and Methods: A retrospective observational study was undertaken at a tertiary care facility between December 2020 and December 2021. Postoperative evaluations were performed at 3, 6, and 18 weeks. A radiographic union assessment was conducted for all participants by the primary investigator. Knee function and stability were quantified using the Knee Society Score (KSS), Lysholm Knee Scoring Scale, and Visual Analogue Scale (VAS). Results: A retrospective pilot study was conducted to evaluate the efficacy of percutaneous fixation for patellar fractures in 15 adult patients. Surgical intervention was performed under spinal anesthesia within five days after the trauma. Postoperative follow-up at 3, 6, and 12 weeks demonstrated significant improvements in knee function, as measured by KSS and Lysholm scores. Radiographic union was achieved in all cases. Patients reported low levels of postoperative pain and high satisfaction rates. Conclusion: Percutaneous fixation of patellar fractures in this small cohort yielded promising early functional and radiological outcomes. Although these preliminary findings are encouraging, larger, long-term studies are necessary to establish the definitive role of this technique.

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