Surgical Methods

Surgical Methods
Open reduction and internal fixation: This is indicated
in transverse fractures of the patella. Internal fixation
is done either by the circumferential wiring or by
tension band wiring (see box). The other methods
are Pyrford technique of circumferential wiring and
a second tension band wiring through the tendon
provide better fixation. Lotke longitudinal anterior
band (LAB) wiring is another method with good
results.
Patellectomy: This could be either partial (for smaller
distal or proximal pole fracture) or complete (for
communited fractures). The emphasis is now on
preserving as much patella as possible.
Surgical Methods
Open reduction and Patellectomy
internal fixation
For transverse fracture
• Martin's circumferential Partial Total
wiring For smaller For
around the patella proximal or comminuted
through the distal pole fractures
surrounding
soft tissues
• Magnuson's
interfragmentary
wiring.
• Tension band wiring
• Modified tension band
wiring (2-K wires with
anterior placement)
• Shaeuwacker's method:
Interfragmentary
screws +
tension band wiring