Plattenosteosynthese bei Patellafrakturen

TY - JOUR

T1 - Plattenosteosynthese bei Patellafrakturen

AU - Müller, E C

AU - Frosch, K-H

PY - 2017/12

Y1 - 2017/12

N2 - OBJECTIVE: Anatomic reconstruction of the retropatellar articular surface and repair of the extensor mechanism of the knee joint. The osteosynthesis should allow immediate mobilization as part of an early functional postoperative rehabilitation protocol.INDICATIONS: Displaced fractures of the patella, especially multifragment and comminuted fractures with a retropatellar incongruity or dislocation of >2 mm.CONTRAINDICATIONS: Critical local soft tissue because of the risk of postoperative infection.SURGICAL TECHNIQUE: Median skin incision. For simple (transverse) fractures, preservation of the soft tissue and reduction control via the index finger. For complex fractures, lateral arthrotomy and eversion of the patella. Reconstruction of the articular surface from the joint side with optimal visibility. Temporary fixation with Kirschner wires, osteosynthesis with the fixed angle plate. If necessary, additional screws or wires.POSTOPERATIVE MANAGEMENT: Immediate mobilization with full weightbearing in full extension with a knee brace. Extension/flexion 0/0/60° for 4 weeks, then 0/0/90° until the 7th week. Active extension after 6 weeks. Climbing stairs after 12 weeks.RESULTS: Good functional results in combination with a low rate of complications and revisions.

AB - OBJECTIVE: Anatomic reconstruction of the retropatellar articular surface and repair of the extensor mechanism of the knee joint. The osteosynthesis should allow immediate mobilization as part of an early functional postoperative rehabilitation protocol.INDICATIONS: Displaced fractures of the patella, especially multifragment and comminuted fractures with a retropatellar incongruity or dislocation of >2 mm.CONTRAINDICATIONS: Critical local soft tissue because of the risk of postoperative infection.SURGICAL TECHNIQUE: Median skin incision. For simple (transverse) fractures, preservation of the soft tissue and reduction control via the index finger. For complex fractures, lateral arthrotomy and eversion of the patella. Reconstruction of the articular surface from the joint side with optimal visibility. Temporary fixation with Kirschner wires, osteosynthesis with the fixed angle plate. If necessary, additional screws or wires.POSTOPERATIVE MANAGEMENT: Immediate mobilization with full weightbearing in full extension with a knee brace. Extension/flexion 0/0/60° for 4 weeks, then 0/0/90° until the 7th week. Active extension after 6 weeks. Climbing stairs after 12 weeks.RESULTS: Good functional results in combination with a low rate of complications and revisions.

KW - English Abstract

KW - Journal Article

KW - Review

U2 - 10.1007/s00064-017-0522-8

DO - 10.1007/s00064-017-0522-8

M3 - SCORING: Review

C2 - 29071377

VL - 29

SP - 509

EP - 519

JO - OPER ORTHOP TRAUMATO

JF - OPER ORTHOP TRAUMATO

SN - 0934-6694

IS - 6

ER -