Krackow sutures combined with vertical Nice stable and reliable in treatment of inferior patellar fractures: study
Xinhui Du et al used a new surgical technique of Krackow suture combined with vertical Nice knot for the treatment of inferior patellar fractures and reported the clinical results. The study was published in ‘Indian Journal of Orthopaedics.’
Seventeen consecutive patients admitted with inferior patellar fractures were prospectively enrolled. The AO classification was 34-A1. All patients underwent open reduction and fixation with Krackow sutures in combination with vertical Nice knot. Postoperative follow-up was performed for at least 1 year to evaluate knee function.
The technique:
Three Kirschner wires (2.0 mm) were drilled through the posterior edge of the proximal fracture surface toward the anterior superior edge of the patella. Three non-absorbable sutures (2–0, Smith & Nephew) were passed through the drill tunnel by varus method, and then, the distal end of the non-absorbable suture was passed through the lower edge of the distal fragments and patellar tendon through the hollow puncture needle. Subsequently, make a reduction of the fracture in the knee-extension position, tightened the sutures separately and use Nice knots to fix the fracture vertically.The patellar tendon was sutured by double Krakow in parallel with non-absorbable suture (2–0, Smith & Nephew). A transverse tunnel was drilled in the proximal patella, and suture was pass through the tunnel and the knot was tightened.
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