THE MODERATE PERIOD OUTCOME THE PARTIAL PATELLECTOMY IN THE TREATMENT OF COMMINUTED PATELLA FRACTURES

The fracture of the biggest sesamoid bone patella is encountered at a rate of 1 % of all skeletal injuries. Partial patellectomy is advised in the treatment of comminuted fractures of patella. In this retrospective study, we evaluated 18 of25 patients who had partial patellectomy in our clinic between 1986-1997. Five patients were female (%27.8) and 13 were male (%72.2). The mechanisms of injuries were as follows: 11 (%61) motor vehicle accidents; 4 (%22) falls from flat-roofed house;2(%11) gunshot; and 1 (%5) subsidence. The mean age of the patients was 34.3 (range,13-65). Ten left (%55) and eight right (%45) partial patellectomy were performed. Ten (%55) patients had also additional pathologies. The median follow-up time was 5.2 years (range, 2-11 years). Patients were very well in the last follow-up. According to Cincinnati Knee Score, which was improved by Noyes, 5 patients (%30) had excellent, 8 (%42) good 3(%17) moderate and 2 (%11) bad results. In conclusion, In the following years, enlargement in patellar articular surface and ossification, which is developed compansatuarly in the extensor mechanism may be detected and mis evaluated as osteoarthrosis. Hence, We determined that they hand not restricted knee joint functions in our cases.

PARÇALI PATELLA KIRIKLARININ TEDAVÝSÝNDE PARSÝYEL PATELLEKTOMÝ'NÝN ORTA DÖNEM SONUÇLARI

Vücudun en büyük sesamoid kemiði olan patellanýn kýrýklarý tüm iskelet yaralanmalarýnýn % 1 'ini oluþturmaktadýr. Parçalý patella kýrýklarýnýn tedavisinde parsiyel patellektomi önerilmektedir. Kliniðimizde 1986-1997 yýllarý arasýnda parçalý patella kýrýðý nedeniyle parsiyel patellektomi yapýlan 25 olgudan takibi yapýlabilen 18 hasta retrospektif olarak deðerlendirildi. Olgularýn 5'i (%27.8) bayan, 13'ü (%72.2) erkekti. Oluþ mekanizmasýna göre; hastalarýn 11'i (%61) trafik kazasý, 4'ü (%22) yüksekten düþme, 2'si (%11) ateþli silah aralanmasý, 1'i (%6) ise göçük altýnda kalma idi. Ortalama yaþ 34.3'tü (13-65). Olgulardan 10'unda (%55) sol, 8'inde (%45) sað dize parsiyel patellektomi uygulandý. Ek patoloji 10 (%56) olguda saptandý. Ortalama 5,2 (3-11) yýl takip edilebilen olgularýn tümünde iyileþme tam olarak görüldü. Sonuçlar Noyes tarafýndan geliþtirilen Cincinnatti diz skoruna göre 5 (%30) hasta mükemmel, 8 (%42) hasta iyi, 3 (%17) hasta orta, 2 (%11) hastada kötü olarak deðerlendirildi. Parsiyel patellektomi, parçalý patella kýrýklarýnda tedavi seçeneðidir. Ýleriki yýllarda görülen pateller eklem yüzeyinde geniþleme ve ekstansör mekanizma içinde kompansatuar olarak geliþen ossifikasyon, osteoartroz gibi deðerlendirilebilir, ancak bunun olgularýmýzýn diz eklemi fonksiyonlarýnda önemli bir kayýp meydana getirmediði görüldü.