EARLY COMPLICATIONS IN THE OPERATIVE TREATMENT OF PATELLA FRACTURES

Objective: To identify and review early complications in the operative treatment of patella fractures. Design: Retrospective review. Setting : Single tertiary care institution with multiple surgeons, including g eneralists and fellowship trained subspecialists. Patients: A consecut ive series of eighty-seven patella fractures over a five year period w as reviewed. Patients treated nonoperatively or with partial or total patellectomy were excluded. Minimum follow-up to fracture healing (fou r months) was available in fifty-one fractures. Intervention: Modified tension band wire fixation was used in ferry-nine fractures, whereas two fractures were treated with tension band wires threaded through ca nnulated screws. Outcome Measures: Early complications such as loss of reduction or fixation, infection, or soft-tissue problems were evalua ted. Results: Displacement of greater than or equal to 2 mm before hea ling was noted in eleven fractures. The displacement could be attribut ed to technical errors in five cases, and to patient noncompliance wit h postoperative activity restrictions in another five cases. Two cases of superficial infection were documented. Nine patients with-symptoma tic hardware required hardware removal. Conclusions: Twenty-two percen t of fractures treated with tension band wiring and early motion displ aced greater than or equal to 2 mm within the early postoperative peri od. Technical errors or patient noncompliance were identified as facto rs. The incidence of early complications in operatively treated patell a fractures is higher than previously reported.