Author/Editor		Kastelec, Matej
Title		Primerjava med operacijami s kovinsko košarico in delnimi odstranitvami pri odkrhnjenih vrška in zdrobljenjih spodnjega dela pogačice
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		1999
Volume		str. 45
Language		slo
Abstract		Operative treatment of the patellar pole avulsion and comminutive distal patellar fractures doesn't have an ideal method of treatment yet. Different operative methods have been proposed, such as using two cerclage wires, Kirschner wires or cancellous lag screw supplemented with a modified anterior tension band, minifragmentation AO plate as a buttress, and metal basket. But as a matter of fact partial patellectomy is the most used method of treatment. In retrospective study we compared two operative methods which were in our clinic chiefly applicated in treatment of comminuted avulsion fractures of the inferior patellar pole. The compared methods are partial patellectomy, and fixation with the metal basket which helps to preserve the entire patella. Between 1990 and 1997 sixty-three patients who suffered an isolated patellar pole avulsion or comminutive distal patellar fracture were treated operatively. 32 patients had a fixation with a metal basket and 31 patients were treated by partial patellectomy. Both groups are comparable in the age distribution, the cause of trauma, the type of fracture, and in the time of operation. 24 patients treated with the metal basket and 30 patients who had a partial patellectomy had been followed for an average 4,3 years (1- 7,8 years), and they were involved in the comprehensive evaluation. In determining of the patellofemoral score, all the patients treated with a metal basket achieved excellent or good result. Amoug patients after partial patellectomy were 27% fair or poor results as well. In the final result is the difference between the two groups statistically significant (p = 0,004). Preservation of comminuted inferior pole in patellar fractures with the metal basket maintains the normal patellar position. Partial patellectomy resulted in patella baja and an increase in the patellofemoral compressive forces. (Abstract truncated at 2000 characters.)
Descriptors		PATELLA FRACTURE FIXATION, INTERNAL ORTHOPEDIC FIXATION DEVICES FRACTURES, CLOSED KNEE INJURIES PATELLAR LIGAMENT