Outcome of Patients with Comminuted Fractures of Patella Treated with Claw Shape Plate, a case Series at a Tertiary Care Hospital

Abstract

Introduction: Comminuted fractures of patella are usually dealt with partial or complete patellectomy which compromise the extensor mechanism. Claw plate is newly introduced device to fix comminuted fractures, which provide easy and efficacious method of preserving patella and is used in selected cases. Methods: This prospective observational case series was conducted at orthopaedic department Chandka Medical College (SMBBMU) Larkana from March 2020 to May 2021. Twenty one cases were selected via consecutive sampling with comminuted fracture of patella who were treated with newly introduced claw shape patellar plate. Age of patients was ranging from 18 years to 70 years. All patients were admitted in tertiary care hospital and were operated by senior surgeon. During procedure patella was approached through anterior mid line incision over knee, fracture reduced and fixed with claw shape patella plate. Post operatively patients were assessed on subsequent follow up visits and outcome of procedure was observed on the basis of functional (Clinical) and radiological results. The functional (clinical) outcome was measured on basis of Lysholm knee score and radiologically x-rays of knee were done to see union pattern. Final outcome of procedure was concluded after 6 month of operation. Results of all patients were compiled and analysed by using statistical package for Social Sciences (SPSS) Version 21 Results: Twenty one patients were enrolled in our study, among them 15(71.4%) were male and six (28.6) were female; the mean age of patients was 42.52 years. The mean length of operation was 55 minutes (40 to 72 minutes). Bone union on radiograph was observed at 20th weeks after surgery in all patients, mean age of fracture healing was 11.5 weeks, (Ranges from 6th to 20th week). At final evaluation found excellent results in 12 (71%) patients, five (29%) patients obtain good results, while four patients lost follow up. Conclusions: Partial or complete patellectomy can be avoided in comminuted patella fractures and patella can be preserved in these fractures by using claw shape patella plate. Keywords: Comminuted fractures, Patella, Claw plate.