Reverse suturing technique in partial patellectomy

Fractures of the patella constitute almost 1% of all skeletal injuries[1], resulting from either direct or indirect trauma. Most patellar fractures are caused by a combination of direct and indirect forces. The most significant effects of fracture of the patella are loss of continuity of the extensor mechanism of the knee and potential incongruity of the patellofemoral articulation. Opinions differ as to the optimal treatment of patellar fractures. Accepted methods include a variety of wiring techniques, screw fixation, partial patellectomy, and total patellectomy. The aim of present study was to analyze the result of partial patellectomy by reverse suturing technique, complications associated with the procedure and restoration of range of motion and function of knee and to evaluate the results clinically regarding pain, activities of daily living, range of motion, power, radiologically regarding failure of procedure. A total of 35 cases of inferior pole patella fracture which were comminuted, extra-articular, closed and fresh were included. They were treated by partial patellectomy (reverse suturing technique). The age of patients in this study ranged from 20-50 yrs. Males formed 68.5% of the patients. Most common cause of fracture in this was direct blow to patella due to fall (62.8%). Duration from injury to surgery was an average of 3.56 days and hospital stay was an average of 4.44 days. Time taken to return to previous level of activity ranged from 8 to 12 weeks. Overall excellent results were obtained in 28 patients and good in 7 patients.