A study on functional and radiological outcomes of patella fracture surgery

Abstract

Patella, being the largest sesamoid bone in the body, plays important role in providing mechanical advantage of the knee extensor mechanism, protecting femoral condyles from injury, and nourishing articular cartilage of distal femur. In general, patella fracture accounts for 1% of all skeletal fractures. This study was designed to evaluate functional and radiological outcomes following patella fracture surgery. 22 cases of patella fractures were surgically treated in Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu between 1st January 2018 and 1st June 2019. Functional outcome was evaluated using Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6 months post-operatively. Radiological outcome was assessed using standard knee joint radiographs at 6 weeks and 12 weeks post-operatively. Majority of patients were Malays (95.5%) and male (72.7%), with the mean age of 37. All of the patients sustained injury either from motor vehicle accident (63.6%) or fall (36.4%). Three surgical fixation techniques were used – tension band wiring, screw fixation and cerclage wiring. The mode of fixations was determined by the surgeons based on fractures type and pattern in accordance to principles of orthopaedic surgery. 16 patients were operated by medical officer while 6 patients were operated by specialist. The mean KOOS outcome subscale scores were: pain 86.0 (range 67-97), symptoms 87.2 (range 57-100), activities of daily living 88.0 (range 56-99), sport/recreation 67.7 (range 25-100), and quality of life 66.8 (range 25-94). Radiologically, all fractures were united after 12 weeks and no fracture fixation failure identified in this study. In conclusion, surgically treated patella fractures provide good to excellent functional and radiological outcomes at short-term follow up.