Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Transosseous Tie Fixation Using Krackow Sutures and Bone Tunnels in a Comminuted Fracture of the Upper Pole of the Patella: A Case Report

  • Baik, Jong Seok (Department of Orthopedic Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine)
  • Received : 2020.12.21
  • Accepted : 2021.03.11
  • Published : 2021.12.30
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Abstract

Comminuted fractures of the patella mostly occur at the inferior pole and require appropriate reduction and fixation to restore the extensor mechanism. Conventional methods such as tension-band wiring are not enough to gain proper fixation strength. Numerous methods have been reported, including circumferential cerclage wiring, osteosynthesis, and suture anchors depending on the fracture pattern. Herein, the author reports a relatively rare case of a comminuted fracture of the upper pole of the patella, for which we used augmented Krackow sutures in the quadriceps and fixation with tying of the suture limbs through patellar bone tunnels. Satisfactory results were obtained in terms of reduction and extensor mechanism recovery.

Keywords

Acknowledgement

This research was supported by grant from Wonkwang University, 2021.

References

  1. Galla M, Lobenhoffer P. Patella fractures. Chirurg 2005;76:987-99. https://doi.org/10.1007/s00104-005-1081-3
  2. Lee BJ, Chon J, Yoon JY, Jung D. Modified tension band wiring using FiberWire for patellar fractures. Clin Orthop Surg 2019;11:244-8. https://doi.org/10.4055/cios.2019.11.2.244
  3. Cho JW, Kim J, Cho WT, Gujjar PH, Oh CW, Oh JK. Comminuted inferior pole fracture of patella can be successfully treated with rim-plate-augmented separate vertical wiring. Arch Orthop Trauma Surg 2018;138:195-202. https://doi.org/10.1007/s00402-017-2807-7
  4. Kim KS, Suh DW, Park SE, Ji JH, Han YH, Kim JH. Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique. Arch Orthop Trauma Surg 2020 Oct 30. doi: 10.1007/s00402-020-03671-5 [Epub ahead of print].
  5. Melvin JS, Mehta S. Patellar fractures in adults. J Am Acad Orthop Surg 2011;19:198-207. https://doi.org/10.5435/00124635-201104000-00004
  6. Chatakondu SC, Abhaykumar S, Elliott DS. The use of non-absorbable suture in the fixation of patellar fractures: a preliminary report. Injury 1998;29:23-7. https://doi.org/10.1016/S0020-1383(97)00114-9
  7. Gosal HS, Singh P, Field RE. Clinical experience of patellar fracture fixation using metal wire or non-absorbable polyester--a study of 37 cases. Injury 2001;32:129-35. https://doi.org/10.1016/S0020-1383(00)00170-4