Application of a Shape-Memory Alloy Concentrator in Displaced Patella Fractures: Technique and Long-Term Results

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Abstract

Operative treatment is usually recommended in displaced patella fractures. Several techniques have been advocated for internal fixation of patella fractures. Despite the relatively good clinical outcomes that have been demonstrated in many studies, postoperative morbidities such as fixation failure, nonunion, infection, and knee stiffness are not uncommon. We present a new alternative treatment technique for displaced patellar fractures. Between April 1995 and May 2005, we used the Nitinol Patella Concentrator (NTPC) to treat 156 consecutive patients with displaced patellar fractures. Injuries arose from vehicular accidents in 56 (35.9%) cases, direct falls onto the knee in 85 (54.5%) cases, and sports injuries in 15 (9.6%) cases. The mean patient age was 46.3 years (range, 25-77 years). Clinical assessments were made using the Böstman knee score and the MOS SF-36 questionnaire (Medical Outcomes Study 36-item short-form health survey), which were both recorded at the final follow-up visit. The mean follow-up was 7.3 years (range, 6-17 years). At the final follow-up, the Böstman knee scores were excellent in 88 cases (28-30), good in 55 (20-27), and unsatisfactory in 13 (<20). According to the MOS SF-36 evaluation, the average score was 84.5 (range, 62-91). Treatment of patellar fracture with the NTPC not only may serve as an effective and rigid fixation method in multifragmented displaced and inferior pole fractures, but also may provide continuous concentrative compression during the osseous healing process. Thus, use of the NTPC may help restore the functional integrity of the extensor mechanism and permit early rehabilitation with a lower incidence of postoperative complications.

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