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Author Topic: Patella fracture repaired by running cable around the tendons - good idea?  (Read 343 times)

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Offline Hobbled

  • MICROgeek (<20 posts)
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I'm 5 weeks out from surgical repair of a fractured patella.  There were six pieces and the OS pulled them together by running a Dall Miles cable around behind the quadriceps tendon at the top, around the patella tendon on the bottom part, and making a "figure 8" across the top of the bone.  I'll try to attach an x-ray.  Note - he said it was a difficult repair and he could not use K Wires.  He did not tunnel through the tendon or go around the bone, and he used no K Wires or screws or other hardware.  The tendons anchor the cable top and bottom.  It is a simple and perfect figure 8.  I've scoured the Internet and can find no other case of a patella repair using this method, running the cable or wire around behind the tendon.  I can understand how this pulls the bone together to heal.  My problem is what is going to happen when I bend the knee and use the muscles so the tendons are pulled tight and interact with the cable. 

Maybe my problem is purely psychological.  I'm about to start PT and I feel tension in the knee when I bend it past a few degrees.  In my mind this is the cable, tight on the joint, pulling on the tendons.  More accurately, it is the tendons pulling sideways against the cable.  It seems to me that when the muscles are used, especially with the knee bent, they will pull against the cable rather than pulling directly on the bone.  I imagine the cable working like a wire cheese cutter, and cutting or damaging the tendons over time. 

I'm hoping someone can report that they had this method of fixation, or that they know someone who did, and it worked out fine.   I'll ask my OS for assurances, but he is proud of his work and I consider him a biased source of information at this point.