[Augmentation of patella fractures and patella tendon ruptures with the McLaughlin-Cerclage].
ABSTRACT Augmentation of patella injuries was first described in 1946 by H.F. McLaughlin. We retrospectively analyzed 14 patients with patella fracture or patella tendon rupture who had been augmented with McLaughlin wiring between 1998 and 2004. The Insall-Salvati ratio was determined before and after removing the cerclage wire as well as on the opposite knee to assess the patella position; in addition the degree of retropatellar arthritis was determined. The functional results were ascertained by Larson and OAK score. McLaughlin wiring influenced the patella position in two patients. Most of the patients achieved a good or very good functional result (mean Larson score 82.39, mean OAK score 82.79). In six patients (42.86%) the degree of retropatellar arthritis was higher than in the opposite knee. Three patients (21.43%) needed secondary arthrolysis at the time of removal of the cerclage. Arthritis and functional results were worse in patients with complex knee trauma. Therefore augmentation with the McLaughlin cerclage in combination with standardized postoperative after treatment is a sufficient therapy of patella fractures and patella tendon ruptures.
Chapter: Patella[Show abstract] [Hide abstract]
ABSTRACT: Es handelt sich um Brüche der Kniescheibe, die meist isoliert auftreten und durch direkte Schädigung verursacht sind. Die häufigste Bruchform ist die Querfrakur, beim Kind Abrissfrakturen der Pole, die bei noch unvollständiger Ossifikation der Nachweisbarkeit im Röntgenbild entgehen können und daher leicht übersehen werden.02/2011: pages 403-415;
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ABSTRACT: Patella fractures are rare and account for approximately 1% of all fractures. They are classified regarding their localization (proximal, distal) and appearance. The aim of any treatment is reconstruction of the extensor mechanism and joint surface. If dislocation and cartilage steps are less than 2 mm, conservative treatment may be indicated. Operative treatment is only necessary if a dislocation is more than 2 mm or when the extensor mechanism is unstable. Depending on the shape of the fracture, tension band wiring, interfragmentary screw fixation and combinations are the main techniques. Because patellectomy has functionally the worst result it should be avoided. Sleeve fractures (children) need exact reconstruction of the joint surface. In elderly patients conservative treatment or surgical patella-enclosing wiring techniques for stabilization are the best options due to low bone quality.Der Orthopäde 09/2011; 40(10):877-80, 882. · 0.51 Impact Factor
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ABSTRACT: Autologous transplantation of the central third of the patella tendon with a bone-patellar tendon-bone (BTB) graft is one of the most commonly used techniques for anterior cruciate ligament (ACL) reconstruction. Frequently chosen alternative sources include semitendinosus and gracilis tendon autografts. The differences of opinion regarding graft sources mainly result from comparison of outcome and complications. Although higher donor site morbidity and postoperative extensor mechanism complications are postulated for bone-patellar tendon-bone grafts, patellar tendon ruptures following anterior cruciate ligament reconstruction are rarely reported in the literature. These predominantly occur during the early postoperative period. We present the case of a patellar tendon rupture in a healthy 36-year-old man, who suffered a skiing accident 10 years after uneventful ACL reconstruction with a BTB graft.Der Unfallchirurg 07/2009; 112(8):728-33. · 0.64 Impact Factor