A prospective study of patellar fracture complications

Patellar fractures are common and constitute about 1% of all skeletal injuries and results because of direct trauma, which causes more comminution whereas indirect injury leads to more displacement with transverse fracture pattern1, 2. Modified tension-band wiring (TBW) technique 6,7,8 is the most widely used technique and has give best results in the operative group. We carried out a prospective study of displaced fracture patella by modified tension band wiring in adults with an objective of evaluating the functional outcome and associated complications. The mean age was 38 years and the incidence was high in the age group of more than 40 years. Mostly indirect injuries came with close type of wound but there were 5 cases of Gustillo-Anderson type 1 of open injuries due to direct injury. In our study we had 23 cases of direct injuries and 7 cases of indirect injuries to patella. Our study included patella fracture from 34C1.1 [transverse] to 34C3.1 [communited] with maximum cases in 34C1.1. The complications are minor which commonly includes hardware prominence due to subcutaneous patellar location but implant removal due to exposed hardware is not common. As for the delayed complications all the fractures united so we had no cases of delayed union or malunion of fracture. But we had a case of migration of pin through the skin after 11 weeks for which K-wire had to be removed. Most of the patellar fractures treated with TBW have good to fair results.