To Study the Outcomes following Combined Management of Fracture Distal End of Femur With Ipsilateral Patella Fracture: A Prospective and Descriptive Study.

Dr. Anurag Dhaker; Dr. Mahendra Jourwal

Volume : VIII, Issue : I, January - 2019

To Study the Outcomes following Combined Management of Fracture Distal End of Femur With Ipsilateral Patella Fracture: A Prospective and Descriptive Study.

Dr. Anurag Dhaker, Dr. Mahendra Jourwal

Abstract :

AIM: To study the outcome following combined management of fracture distal end of femur with ipsilateral patellar fracture. METHODS: A hospital based Prospective, Interventional and Descriptive study was done at Department of Orthopedics , SMS Jaipur to compare the functional outcome (range of motion) and fracture healing following different modes of treatment in Supracondylar femur fracture with Ipsilateral fractured patella. A total of 35 patients fulfilling the inclusion criteria and excluding the exclusion criteria were included in the study after taking the written informed consent. Preoperative evaluation and X-Ray were done. They were then taken for surgical fixation. Femur fracture was fixed with Locking Compression Plate and Patellar Fracture was fixed with K-Wire Tension Band Wiring (TBW) , Encirclage , Patellectomy or conservative treatment. Postoperatively, Wound inspection was done on 2nd , 5th and 8th day. Sutures were removed on 15th day and patients were followed at 2nd , 6th ,10th week and 3rd month. Range of motion , time for radiological union and time required for weight be� were recorded at every visit. Patient�s functional results were evaluated using Friedman and Wyman scoring system . At the end of 3 months, the observations were compared and statistically analysed. RESULTS: After 3 months of follow up, Average age of presentation was 39.88+14.50 years. 82% patients were males. Locking compression plate was the most common method for fixation of supracondylar femur fracture. K-wire TBW was satisfactory method of reducing fractures of patella & helped in acquiring greater range of motion (p<0.001). Operating fracture patella along with distal femoral fractures helped in achieving greater range of movement (ROM) as compared to adopting conservative methods (P<0.001). CONCLUSION: Combined operative management of fractures of distal femur & patella have better restoration of ROM