Cable-pin fixation for treatment of patellar inferior pole fractures

Objective To investigate the feasibility and clinical efficacy of Cable-pin technique for fractures of patellar inferior pole.Methods From June 2009 to February 201 1,35 patients with fresh patellar inferior pole fracture ( 19 males and 16 females,35 to 74 years of age,with an average of 51.4 years)were treated with Cable-pin technique.There were 4 cases of traffic injury,26 cases of falling injury and 5 cases of sports injury.The average time from injury to surgery was 2.4 days (from 0 to 7 days).The patellar contour was first restored by sutures after fracture reduction,followed by figure-of-8 fixation with Cable-pin technique,and wire ring fixation if necessary.The Bostman evaluation system,follow-up X-ray,and knee mobility were used to analyze the clinical efficacy of Cable-pin technique.Results All patients obtained a mean follow-up of 10.2 months (from 6 to 15 months).No internal fixation failure was observed 3 months post-surgery and bony union was achieved in all cases 6 months post-surgery.The mean Bostman functional score for patellar fractures was 29.4 points 6 months post-surgery.There were 29 excellent cases and 6 good ones with a good to excellent rate of 100％.The knee stability was fine in all cases.The ranges of motion at the last follow-up were:average extension of -0.5° degree and average flexion of 124.0°.All patients obtained muscle strength of Grade 5 for the quadriceps femoris of the affected limb.Two patients suffered subcutaneous tenderness which disappeared after removal of internal implants.Conclusion Cable-pin technique is a good alternative treatment of inferior fracture of the patella,because it can provide excellent initial stability and lead to early rehabilitation exercise and limited complications. Key words: Patella;  Fractures;  Fracture fixation, internal;  Treatment outcome