Sound union was achieved in all the fractures. That was proved clinically and radiologically. The CEF device was removed at 6 to 8 weeks. Tensioning of the wires and compression of the fractures are done by distracting the clamps from one another by turning the distraction nut until the tension wires are tight. The fragments are reduced by clamp. The remaining 13 cases were performed through an open procedure. The wound is closed aseptically. Table 1 Patients Type of fractures Insall knee score 12 Transverse All the surgeries were performed under spinal anesthesia.
The traditional method for patella fracture is tension band wiring TBW which provides sound union in most cases [4, 5, 6, 7, 9]. CEF technique is a safe and effective method of treatment in patella fractures with advantages over traditional methods in case with a poor soft tissue envelope. The following atypical patterns were also treated: The wires are passed through the related holes in the clamp assembly. We must palpate the articular surface from side to side to confirm the accurate reduction. Loss of reduction, and loss of motion, infection and need for second surgery were defined as negative outcomes. The fragments are reduced by clamp. The technique is based on tensioned biocompatible thin wire external fixation as developed by Academician Prof. Tensioning of the wires and compression of the fractures are done by distracting the clamps from one another by turning the distraction nut until the tension wires are tight. We are reporting here, the Afgan compressive external fixator which was introduced by my friend Mr. All the patients were allowed to do movements in the joints and weight bearing postoperatively. However the nature of patella and high tensile forces challenge the standard surgical techniques used for fracture. After 1st operative day it is necessary to clean the wire sites with rectified spirit or any kind of antiseptic solution. Recent traditional treatment of patella fractures are related with infection and failure of fixation. Minor complications like wire inflammation was observed in 5 patients which was treated by local care and antibiotics. This allows for bowing of the wires and compression of the fracture during tensions of the device. The transverse fracture of patella with displacement were treated by compressive external fixation, based on Ilizarov tensioned wire construct. The wires are secured by the nuts on the clamp assembly. All the 25 patients were treated by CEF. Patient follow up was continued at an average of 4 years postoperatively range years. The CEF device was removed at 6 to 8 weeks. It is to be noted that the wire pairs be as far from fracture line as possible. No drains are used. Ilizarov for long bones, allows limitless motion [1, 2]. Our aim and purpose of this technique is to review the functional outcomes of patients treated with this novel method. When the fragments are displaced, then surgery is absolutely indicated to maintain the function of the extensor mechanism. Upper pole fracture - 2; Stellate fracture - 2; Three part fracture - 4.
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