Pointed reduction clamps are also utilized to achieve and maintain reduction (Figure 2). When possible, care should be taken to place Krischer-wires in locations that will not interfere with placement of the final plate construct. For definitive fixation, a Synthes 2.4/2.7 mesh plate (Synthes; West Chester, PA) is cut and contoured for application circumferentially to the lateral half of the patella. The plate design
permits extension beneath the patellar tendon distally and quadriceps tendon proximally while extending over the anterior surface of the patella with the two remaining limbs. We typically utilize one of two specific plate patterns based on patient size and the shape of the patella (Figure 3). The shape is intended to allow for an anterior/transverse limb extending over both the primary proximal and distal fragments, but modifications are made based on patient size and fracture pattern. Superior and inferior extensions of the plate should be placed directly on the
bony surface beneath the quadriceps and patellar tendons, respectively. Care should be taken to ensure that tendinous insertions are not compromised. Lateral to medial transverse bicortical screws should be placed in the superior and inferior poles to seat the plate and to obtain initial fixation of the two major fracture fragments. Final contouring of superior, inferior and anterior/transverse limbs is then performed. Care should be taken to ensure that the edge of the plate approximates but does not overlap the articular surface throughout its entirety (Figure 4).
ที่หนีบลดแหลมยังถูกนำมาใช้เพื่อให้บรรลุและรักษาลดลง เมื่อเป็นไปได้ควรดูแลที่จะวางสาย สำหรับการตรึงที่ชัดเจนเป็น Pointed reduction clamps are also utilized to achieve and maintain reduction (Figure 2). When possible, care should be taken to place Krischer-wires in locations that will not interfere with placement of the final plate construct. For definitive fixation, a Synthes 2.4/2.7 mesh plate (Synthes; West Chester, PA) is cut and contoured for application circumferentially to the lateral half of the patella. The plate design
permits extension beneath the patellar tendon distally and quadriceps tendon proximally while extending over the anterior surface of the patella with the two remaining limbs. We typically utilize one of two specific plate patterns based on patient size and the shape of the patella (Figure 3). The shape is intended to allow for an anterior/transverse limb extending over both the primary proximal and distal fragments, but modifications are made based on patient size and fracture pattern. Superior and inferior extensions of the plate should be placed directly on the
bony surface beneath the quadriceps and patellar tendons, respectively. Care should be taken to ensure that tendinous insertions are not compromised. Lateral to medial transverse bicortical screws should be placed in the superior and inferior poles to seat the plate and to obtain initial fixation of the two major fracture fragments. Final contouring of superior, inferior and anterior/transverse limbs is then performed. Care should be taken to ensure that the edge of the plate approximates but does not overlap the articular surface throughout its entirety (Figure 4).
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