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Die Zuggurtungsosteosynthese nach Patellafraktur

Komplikationen und mittelfristige klinische Ergebnisse

Dynamic cerclage wiring of patellar fractures

Complications and midterm functional results

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Zusammenfassung

Hintergrund

Zur Vermeidung einer Retropatellararthose sind der Erhalt der Patella und ihre anatomische Reposition nach Patellafraktur unabdingbar.

Material und Methoden

Wir analysierten die Daten von 50 Patienten mit Zuggurtungsosteosynthese der Patella bezüglich der Komplikationen. Zusätzlich konnten 37 dieser Patienten zur Nachuntersuchung einbestellt und die funktionellen Ergebnisse anhand des Tegner- und Lysholm-Scores erhoben werden.

Ergebnisse

Minor-Komplikationen traten in 50% und Major-Komplikationen in 30% der Fälle auf. Trotz der hohen Komplikationsrate hatten 70% der nachuntersuchten Patienten sehr gute bis gute objektive (Kniefunktion und Aktivität) bzw. subjektive Ergebnisse (Schmerzen und Zufriedenheit). Ein schlechtes Ergebnis trat in 10% der Fälle auf. Eine Korrelation der Frakturschwere mit der Komplikationsrate oder dem postoperativen objektiven Ergebnis bestand nicht.

Schlussfolgerung

Die operative Versorgung von Patellafrakturen ist und bleibt anspruchsvoll. Obwohl die Mehrzahl der nachuntersuchten Patienten sehr zufrieden ist und gute bis exzellente Ergebnisse aufweist, sollte die hohe implantatbedingte Komplikationsrate Anlass sein, auch andere Methoden der operativen Stabilisierung in Betracht zu ziehen, um hier die Ergebnisse weiter zu optimieren.

Abstract

Background

Preserving the patella and its accurate anatomic reduction after fracture is extremely important to avoid retropatellar arthrosis.

Methods

The data of 50 patients with patellar fractures treated by cerclage wiring was analyzed in relation to complications. In addition, 37 patients were called in for follow-up examination, and the functional results were assessed according to the Tegner and Lyshom scores.

Results

Minor complications occurred in 50% and major complications in 30% of cases. Despite the high complication rate, 70% of the examined patients revealed excellent to good objective or subjective results, while 10% of the patients showed poor results. No correlation existed between the fracture severity and the complication rate on the one hand or the postoperative objective outcome on the other hand.

Conclusion

Operative treatment of patellar fractures is still demanding. Although most of the examined patients were quite satisfied and demonstrated excellent to good results, the high complication rate is reason to take other methods of internal fixation into consideration to further optimize results.

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  1. Klinik für Unfall- und Handchirurgie, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    M. Wild, T. Khayal, D. Miersch, J. Windolf & M. Hakimi

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  1. M. Wild
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  2. T. Khayal
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  3. D. Miersch
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  4. J. Windolf
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  5. M. Hakimi
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Correspondence to M. Wild.

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Wild, M., Khayal, T., Miersch, D. et al. Die Zuggurtungsosteosynthese nach Patellafraktur. Unfallchirurg 111, 892–897 (2008). https://doi.org/10.1007/s00113-008-1505-x

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