Superior Outcomes After Operative Fixation of Patella Fractures Using a Novel Plating Technique: A Prospective Cohort Study.

Abstract:

OBJECTIVE:The purpose of this prospective cohort study was to determine if a new patella fracture fixation construct resulted in improved outcomes compared with traditional tension band techniques. DESIGN:Comparative cohort study. SETTING:Academic level I trauma center. PATIENTS/PARTICIPANTS:Patients with isolated, unilateral patellar fractures were enrolled prospectively. From 2012 to 2014, 33 patients underwent fixation with a novel plate construct that spans half of the patella circumference laterally and provides multiplanar fixation through a low-profile plate. A comparison cohort was drawn from 25 patients treated from 2008 to 2012, where treatment consisted of traditional tension band fixation techniques. INTERVENTION:Surgical fixation of patella fractures was performed with either a tension band or novel plate construct. MAIN OUTCOME MEASUREMENTS:Subjective postoperative clinical outcomes and objective functional and strength measurements were subsequently collected. RESULTS:The 2 cohorts had similar baseline characteristics. Patients with the plate construct had clinically and statistically significantly superior Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) scores throughout the study period (P < 0.001). Functional testing also demonstrated significant improvements in patients with plate constructs compared with tension band constructs at 12 months. Patients in the plate cohort had significantly increased thigh circumferences (P = 0.003) and decreased anterior knee pain (P < 0.0001) compared with the tension band cohort. CONCLUSIONS:In this prospective cohort study, the use of a novel fixation construct with multiplanar and interfragmentary fixation and minimal disruption of patellar vascularity enables improved clinical outcomes and functional performance. LEVEL OF EVIDENCE:Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

authors

Lorich DG,Fabricant PD,Sauro G,Lazaro LE,Thacher RR,Garner MR,Warner SJ

doi

10.1097/BOT.0000000000000787

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

241-247

issue

5

eissn

0890-5339

issn

1531-2291

journal_volume

31

pub_type

杂志文章
  • A Review of Atypical Femoral Fractures From a Tertiary Care Teaching Hospital: An Alarming Trend?

    abstract:OBJECTIVE:To evaluate the experience of a single tertiary care teaching hospital with the association between use of bisphosphonates and atypical femoral fractures, and to identify potential risk factors and chronologic incidence. DESIGN:Retrospective review. SETTING:Tertiary-care teaching hospital. PATIENTS:Thirty-...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0000000000000539

    authors: Black JD,Kancherla VK,De Long WG Jr

    更新日期:2016-04-01 00:00:00

  • Fluoroscopically guided hip capsulotomy: effective or not? A cadaveric study.

    abstract:OBJECTIVE:The purpose of this study was to examine the efficacy of a fluoroscopically guided hip capsulotomy. METHODS:Ten fresh-frozen paired cadaveric hips were injected under fluoroscopic guidance with saline sufficient to generate an intra-articular pressure greater than 58 mmHg. The pressure was monitored continuo...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3181e93cbe

    authors: Christal AA,Taitsman LA,Dunbar RP Jr,Krieg JC,Nork SE

    更新日期:2011-04-01 00:00:00

  • Convergent radioulnar translocation with radial head fracture in a child: a case report and review of the literature.

    abstract:SUMMARY:Convergent type radioulnar translocation is an extremely rare form of injury occurring in a growing child. We report a case of convergent radioulnar translocation along with a radial head fracture in a young child. Open reduction of the elbow and internal fixation of the radial head fragment helped in achieving...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0b013e31821d7fd5

    authors: Agashe MV,Samant A,Aroojis AJ

    更新日期:2012-04-01 00:00:00

  • Biomechanical Assessment of Locking Plate Fixation of Comminuted Proximal Olecranon Fractures.

    abstract:OBJECTIVES:To determine if mean ultimate strength or failure mechanism differed between comminuted olecranon fractures created at the proximal 25% or 50% of the trochlear notch and fixed with precontoured posterior locking plates (PLPs). METHODS:Comminuted osteotomies were created in 10 matched pairs of cadaveric uppe...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001279

    authors: Fantry A,Sobel A,Capito N,Hodax JD,Pidgeon T,Koruprolu S,Rich R,Fava JL,Green A,Paxton S

    更新日期:2018-11-01 00:00:00

  • Inadvertent intraforaminal iliosacral screw placement despite apparent appropriate positioning on intraoperative fluoroscopy.

    abstract::We present the case of an intraforaminal iliosacral screw placed percutaneously with aid of C-arm using inlet, outlet, and lateral views of the pelvis. The iliosacral screw was placed above the S1 foramen on the outlet view, into the middle of S1 via the ala on the inlet view, and below the cortical shadow of the ala ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200502000-00010

    authors: Sagi HC,Lindvall EM

    更新日期:2005-02-01 00:00:00

  • The protective effect of locking screw placement on nonlocking screw extraction torque in an osteoporotic supracondylar femur fracture model.

    abstract:OBJECTIVE:To examine the impact of number and position of locking screws in the diaphyseal portion of an osteoporotic distal femoral fracture model with hybrid fixation. METHODS:Four groups containing 5 osteoporotic bone models were used with varying combinations of diaphyseal screw fixation: 4 nonlocking screws (cont...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318238c086

    authors: Dalstrom DJ,Nelles DB,Patel V,Goswami T,Markert RJ,Prayson MJ

    更新日期:2012-09-01 00:00:00

  • Predictors of Unplanned Reoperation After Operative Treatment of Pelvic Ring Injuries.

    abstract:OBJECTIVES:To evaluate the incidence of unplanned reoperations after pelvic ring injuries and to develop a risk prediction model. DESIGN:Retrospective review. SETTING:Level I Trauma Center. PATIENTS:The medical records of 913 patients (644 male and 269 female patients; mean age, 39 years; age range, 16-89 years) wit...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001170

    authors: Ochenjele G,Reid KR,Castillo RC,Schoonover CD,Montalvo RN,Manson TT,Sciadini MF,Nascone JW,Carlini AR,OʼToole RV

    更新日期:2018-07-01 00:00:00

  • Inflammation, Bone Healing, and Anti-Inflammatory Drugs: An Update.

    abstract::Fracture healing is a unique multifaceted process requiring the presence of cells, molecular mediators, and angiogenic factors. The state of inflammation dominates the initial phase, but the ideal magnitude and duration of the process for an optimal outcome remains obscure. Biological response modifiers, such as plate...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0000000000000465

    authors: Giannoudis PV,Hak D,Sanders D,Donohoe E,Tosounidis T,Bahney C

    更新日期:2015-12-01 00:00:00

  • Comparison of Outcomes of Intertrochanteric Fracture Fixation Using Percutaneous Compression Plate Between Stable and Unstable Fractures in the Elderly.

    abstract:OBJECTIVES:To evaluate the outcomes of treatment with a percutaneous compression plate (PCCP) in stable and unstable intertrochanteric hip fractures. DESIGN:Clinical prospective nonrandomized cohort study. SETTING:San Cecilio University Hospital, Granada (Spain). A tertiary-care hospital. PATIENTS:Patients older tha...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000509

    authors: Carvajal-Pedrosa C,Gómez-Sánchez RC,Hernández-Cortés P

    更新日期:2016-06-01 00:00:00

  • Teamwork in Trauma: System Adjustment to a Protocol for the Management of Multiply Injured Patients.

    abstract:OBJECTIVES:We developed a protocol to determine the timing of definitive fracture care based on the adequacy of resuscitation. Inception of this project required a multidisciplinary group, including physicians from anesthesiology, general trauma and critical care, neurosurgery, orthopaedic spine, and orthopaedic trauma...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000383

    authors: Vallier HA,Moore TA,Como JJ,Dolenc AJ,Steinmetz MP,Wagner KG,Smith CE,Wilczewski PA

    更新日期:2015-11-01 00:00:00

  • Biomechanical evaluation of the less invasive stabilization system for the internal fixation of distal femur fractures.

    abstract:OBJECTIVE:Comparison between a Less Invasive Stabilization System (LISS) using monocortical screws with angular stability and two conventional plate systems Condylar Buttress Plate (CBP) and Dynamic Condylar Screw (DCS) for the treatment of distal femoral fractures with respect to biomechanical properties. DESIGN:Biom...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200109000-00004

    authors: Marti A,Fankhauser C,Frenk A,Cordey J,Gasser B

    更新日期:2001-09-01 00:00:00

  • Levels of Evidence in Orthopaedic Trauma Literature.

    abstract:OBJECTIVE:To review and critically assess trends observed regarding the levels of evidence in published articles in orthopaedic traumatology literature. DATA SOURCES:The Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery-American, and Clinical Orthopaedics and Related Research. STUDY SELECTION:All artic...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0000000000000557

    authors: Scheschuk JP,Mostello AJ,Lombardi NJ,Maltenfort MG,Freedman KB,Tjoumakaris FP

    更新日期:2016-07-01 00:00:00

  • Cross-sectional geometry of the sacral ala for safe insertion of iliosacral lag screws: a computed tomography model.

    abstract:OBJECTIVE:To measure the dimensions of the narrowest portion of the sacral ala for safe insertion of iliosacral lag screws. DESIGN:Computed tomography (CT) model. SETTING:Level One trauma center. PATIENTS:Thirteen adult patients underwent pelvic CT imaging. MAIN OUTCOME MEASURE:Axial CT scans of intact pelves were ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200001000-00007

    authors: Noojin FK,Malkani AL,Haikal L,Lundquist C,Voor MJ

    更新日期:2000-01-01 00:00:00

  • Does the Coexistence of Multiple Segmental Rib Fractures in Polytrauma Patients Presenting With "Major" Vertebral Fracture Affect Care and Acute Outcomes?

    abstract:OBJECTIVE:To determine whether operating on "major" vertebral fractures leads to premature abortion of surgery and/or other acute cardiopulmonary complications. DESIGN:Retrospective review. CLINICAL SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS AND INTERVENTION:We retrospectively queried our institutional Tra...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001316

    authors: Alvi MA,Kapurch JR 2nd,Ivanov DV,Kerezoudis P,Bydon M,Freedman BA

    更新日期:2019-01-01 00:00:00

  • Management protocol for unreamed interlocking tibial nails for open tibial fractures.

    abstract::Over a 15-month period, 41 open grade I-IIIA tibia fractures were treated with unreamed interlocking nails. A protocol previously established by the authors to enhance fracture union was followed. The purpose of the study was to determine if union rate for the comminuted statically locked fracture could be reduced thr...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199504000-00005

    authors: Stegemann P,Lorio M,Soriano R,Bone L

    更新日期:1995-04-01 00:00:00

  • Fractures of the ipsilateral femur and tibia: emphasis on intra-articular and soft tissue injury.

    abstract::Twenty-one patients with fractures of the ipsilateral femur and tibia were treated at Boston City Hospital from 1982 through 1987. Fourteen (67%) of the 21 patients sustained a total of 17 open fractures (76% of which were grade II or III wounds). Over 50% of the patients suffered concomitant ipsilateral knee injuries...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199004030-00013

    authors: Paul GR,Sawka MW,Whitelaw GP

    更新日期:1990-01-01 00:00:00

  • Minimally invasive plate osteosynthesis of humeral shaft fractures: a technique to aid fracture reduction and minimize complications.

    abstract:OBJECTIVES:To introduce a modified operative technique for minimally invasive plate osteosynthesis (MIPO) for acute displaced humeral shaft fractures and to evaluate the clinical and radiological outcomes. DESIGN:: Prospective clinical series study. SETTING:University hospital. PATIENTS:Twenty-one patients with acut...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318254895f

    authors: Shin SJ,Sohn HS,Do NH

    更新日期:2012-10-01 00:00:00

  • Traumatic avulsion of the triceps brachii.

    abstract::Traumatic avulsion of the triceps brachii tendon is a rare injury. Clinical diagnosis shows that elbow extension against gravity is not possible. Radiologically, the lateral elbow may show the presence of flecks of avulsed osseous material from the olecranon ("flake sign"), which is almost pathognomonic of this lesion...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200204000-00010

    authors: Pina A,Garcia I,Sabater M

    更新日期:2002-04-01 00:00:00

  • Biomechanical comparison of polyaxial and uniaxial locking plate fixation in a proximal tibial gap model.

    abstract:OBJECTIVES:Lateral locked plating for proximal tibial fractures with metaphyseal disruption provides a biomechanically stable and biologically favorable alternative to conventional medial/lateral plate fixation. New polyaxial screw technology incorporates expanding screw bushings, allowing variable angle screw placemen...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/QAI.0b013e3181a25368

    authors: Cullen AB,Curtiss S,Lee MA

    更新日期:2009-08-01 00:00:00

  • Oblique screws at the plate ends increase the fixation strength in synthetic bone test medium.

    abstract:OBJECTIVE:To test the hypothesis that oblique screws at the ends of a plate provide increased strength of fixation as compared to standard screw insertion. DESIGN:Biomechanical laboratory study in synthetic bone test medium. METHODS:Narrow 4.5-mm stainless steel low-contoured dynamic compression plates were anchored ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200410000-00006

    authors: Stoffel K,Stachowiak G,Forster T,Gächter A,Kuster M

    更新日期:2004-10-01 00:00:00

  • Clinical and finite element analysis of a modular femoral prosthesis consisting of a head and stem component in the treatment of pertrochanteric fractures.

    abstract:OBJECTIVE:To determine the biomechanical characteristics and potential clinical efficacy of a cementless modular femoral prosthesis consisting of a variable head (50 to 80 millimeters) and stem (length 120 to 280 millimeters, diameter 10 to 20 millimeters) component in patients with pertrochanteric femoral fracture. D...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200011000-00005

    authors: Andress HJ,Kahl S,Kranz C,Gierer P,Schürmann M,Lob G

    更新日期:2000-11-01 00:00:00

  • Unexpected high complication rate following internal fixation of unstable proximal humerus fractures with an angled blade plate.

    abstract:OBJECTIVES:The increasing number of fractures of the proximal humerus, especially in the elderly, carries with it the unsolved problem of the optimal treatment for the displaced or unstable fractures. The authors' goal was to analyze whether fixation with a bent valgus angled blade plate could improve the outcomes repo...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200604000-00004

    authors: Meier RA,Messmer P,Regazzoni P,Rothfischer W,Gross T

    更新日期:2006-04-01 00:00:00

  • A Novel Traction Frame for Femur Fracture Management in Developing Countries: Technique and Outcomes.

    abstract::Fractures of the femur have long been a major cause of morbidity and mortality in developing countries and are most frequently caused by road traffic accidents. Intramedullary nail fixation has become the gold standard of care for diaphyseal fractures of the femur. However, modern techniques require proper implants, a...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,多中心研究

    doi:10.1097/BOT.0000000000001407

    authors: Levy DM,Meadows MC,Gates DJ

    更新日期:2019-05-01 00:00:00

  • Biomechanical testing of a new design for Schanz pedicle screws.

    abstract::Standard 5-mm AO Schanz pedicle screws were biomechanically compared with a new design, featuring 6-mm threads with a 5-mm core diameter continuous with the shaft. One each of the two screw designs was surgically inserted into the matching pedicles of 32 cadaveric vertebrae. The pull-out strengths of the screws were t...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199308000-00015

    authors: Willett K,Hearn TC,Cuncins AV

    更新日期:1993-01-01 00:00:00

  • The role of negative pressure wound therapy with reticulated open cell foam in the treatment of war wounds.

    abstract::The treatment of war wounds poses many unique challenges to all healthcare providers (surgeons, flight medics, nurses, etc.), whether they are located at the far forward trauma hospitals located in or near areas of conflict, at regional hospitals such as Landstuhl Medical Center in Germany, or the larger military hosp...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0b013e318188e27d

    authors: Powell ET 4th

    更新日期:2008-11-01 00:00:00

  • Getting organized in your job.

    abstract::The benefits of being organized when starting one's career are countless and worth the time and effort in developing an effective and efficient practice. Established protocols, good habits, and methodical communication that include all members of the team will help create a system that keeps all components of one's pr...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182a52344

    authors: Siegel J

    更新日期:2013-10-01 00:00:00

  • Acute vascular injury associated with fracture of the distal radius: a report of 6 cases.

    abstract:OBJECTIVES:To highlight the potential for vascular injury with fracture of the distal radius. DESIGN:Retrospective case series. SETTING:The practices of several orthopaedic hand surgeons. PATIENTS/PARTICIPANTS:Six patients with arterial injury as a consequence of fracture of the distal radius: 2 partial lacerations ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318188d686

    authors: de Witte PB,Lozano-Calderon S,Harness N,Watchmaker G,Green MS,Ring D

    更新日期:2008-10-01 00:00:00

  • Using a Validated Middle-Age and Geriatric Risk Tool to Identify Early (

    abstract:OBJECTIVES:(1) To demonstrate that a validated trauma triage score for middle-aged and geriatric patients could identify those at high risk of mortality within the first 2 days of hospitalization and (2) determine the cost of care for this cohort of patients. DESIGN:Prospective cohort study. SETTING:Single level 1 tr...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001187

    authors: Lott A,Haglin J,Saleh H,Hall J,Egol KA,Konda SR

    更新日期:2018-07-01 00:00:00

  • Operating room efficiency: benefits of an orthopaedic traumatologist at a level II trauma center.

    abstract:OBJECTIVES:Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical servi...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182a59d6b

    authors: Althausen PL,Kauk JR,Shannon S,Lu M,O'Mara TJ,Bray TJ

    更新日期:2014-05-01 00:00:00

  • Locked plating of periprosthetic femur fractures above total knee arthroplasty.

    abstract:BACKGROUND:Fractures of the femur above a total knee arthroplasty (TKA) are becoming increasingly common in the osteoporotic, aging populations of developed countries. Treatment of these fractures is complicated by the presence of a knee prosthesis, frequently limiting the bone available for distal fracture fixation. T...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31822c050b

    authors: Hou Z,Bowen TR,Irgit K,Strohecker K,Matzko ME,Widmaier J,Smith WR

    更新日期:2012-07-01 00:00:00