Observations On The Outcome Of Perry’s Load-Sharing Patello-Tibial Cable Augmentation In Comminuted Lower Pole Patellar Fractures Managed By Partial Patellectomy

Abstract

Introduction: Lower pole patellar fractures are usually avulsion fractures and have associated tears of the joint capsule with damage to the extensor mechanism. Due to this reason, most of these fractures require surgical treatment in the form of internal fixation or partial patellectomy. However, these methods have high rates of knee stiffness due to the need of prolonged immobilization after surgery. Partial patellectomy with patella-tibial cable augmentation using the modified Perry’s technique aims to get better functional results by encouraging early knee movements. 

Aim: The present prospective study was conducted to evaluate the results of partial patellectomy with patella-tibial cable augmentation using modified Perry’s technique in comminuted lower pole patella fractures.

Materials and Methods: Thirty adult patients with fractures of the lower pole of the patella underwent load sharing patello-tibial cable augmentation after partial patellectomy and the results were noted.

Results: The results were evaluated using the Bostman score at 9 months and the score ranged from 23 to 30, with a mean score of 28.3. Twenty-one (70%) patients had an excellent result and nine (30%) patients had a good result with no patient having an unsatisfactory outcome. The most common complication encountered was the breakage of the wire (16.66%). The results of the study show the use of a load-sharing wire or cable offers significant advantages over conventional lower pole excision and cast application in terms of stability and rehabilitation.

Conclusion: Augmentation with patellotibial wire following partial patellectomy helps to shorten the rehabilitation time and return to work in patellar fractures avoiding cumbersome immobilisation.