Analysis of postoperative complications 5 years after osteosynthesis of patella fractures-a retrospective, multicenter cohort study.

Autor: Berninger MT; Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. m.berninger@uke.de., Korthaus A; Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Eggeling L; Department of Trauma, Orthopaedic Surgery, and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany., Herbst E; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany., Neumann-Langen MV; Department of Orthopaedic and Trauma Surgery, Klinikum Konstanz, Constance, Germany., Domnick C; Department of Trauma, Hand and Orthopedic Surgery, Euregio-Hospital, Nordhorn, Germany., Fehske K; Department of Orthopaedic and Trauma Surgery, Johanniter Waldkrankenhaus, Bonn, Germany.; Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Würzburg, Germany., Barzen S; Department of Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt Am Main, Frankfurt Am Main, Germany., Kösters C; Department of Orthopedics and Trauma Surgery, Maria and Josef Hospital, Greven, Germany., Zellner J; Sporthopaedicum Regensburg, Regensburg, Germany., Raschke MJ; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany., Frosch KH; Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Department of Trauma, Orthopaedic Surgery, and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany., Hoffmann R; Department of Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt Am Main, Frankfurt Am Main, Germany., Krause M; Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jazyk: angličtina
Zdroj: European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2024 Aug; Vol. 50 (4), pp. 1691-1699. Date of Electronic Publication: 2024 Apr 03.
DOI: 10.1007/s00068-024-02503-0
Abstrakt: Purpose: The study aims to investigate the influence of patient- and fracture-specific factors on the occurrence of complications after osteosynthesis of patella fractures and to compare knee joint function, activity, and subjective pain levels after a regular postoperative course and after complications in the medium term.
Methods: This retrospective, multicenter cohort study examined patients who received surgery for patella fracture at level 1 trauma centers between 2013 and 2018. Patient demographics and fracture-specific variables were evaluated. Final follow-up assessments included patient-reported pain scores (NRS), subjective activity and knee function scores (Tegner Activity Scale, Lysholm score, IKDC score), complications, and revisions.
Results: A total of 243 patients with a mean follow-up of 63.4 ± 21.3 months were included. Among them, 66.9% of patients underwent tension band wiring (TBW), 19.0% received locking plate osteosynthesis (LPO), and 14.1% underwent screw osteosynthesis (SO). A total of 38 patients (15.6%) experienced complications (TBW: 16.7%; LPO: 15.2%; SO: 11.8%). Implant-related complications of atraumatic fragment dislocation and material insufficiency/dislocation, accounted for 50% of all complications, were significantly more common after TBW than LPO (p = 0.015). No patient-specific factor was identified as a general cause for increased complications. Overall, particularly following complications such as limited range of motion or traumatic refracture, functional knee scores were significantly lower and pain levels were significantly higher at the final follow-up when a complication occurred. Implant-related complications, however, achieved functional scores comparable to a regular postoperative course without complications after revision surgery.
Conclusion: The present study demonstrated that implant-related complications occurred significantly more often after TBW compared to LPO. The complication rates were similar in all groups.
(© 2024. The Author(s).)
Databáze: MEDLINE
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