Internal fixation of transverse patellar fracture by tension band wiring combined with cannulated compression screws / 中华骨科杂志

ABSTRACT

Objective To explore the clinical results of internal fixation of patellar transverse body fracture by comparing figure-of-eight tension band wiring combined with cannulated compression screws technique with traditional modified tension band (AO technique). Methods There were 14 cases in the cannulated screws combined with tension band wire group, it involved 9 males and 5 females, the average age was 46 years. The patients were followed up for an average of 30 weeks with a range from 16 to 48 weeks. Another 20 cases were in the modified tension band group, it involved 13 males and 7 females, the average age was 42 years. The patients were followed up for an average of 42 weeks with a range from 36 to 72 weeks. The t test was used to compare the clinical results between two groups, including the mean knee flexion at the 2nd and 4th week, the mean clinical union time and the mean flexion loss at the 24th week postoperatively. Results In the cannulated screws combined with tension band wire group, the mean knee flexion at the 2nd week and 4th week postoperatively was 59??14.8? and 98??15.1? respectively. The mean clinical union time was (10?3.0) weeks and the mean flexion loss at the 24th week postoperatively was 11??6.3? without any complication. In the traditional modified tension band group, the mean knee flexion at the 2nd week and 4th week was 31??13.3? and 63??13.7? respectively. The mean clinical union time was (13?3.8) weeks and the mean flexion at the 24th week postoperatively was 18??6.2?. In this group, 2 cases failed because loosening of the tension band with the pin pulled out. One was managed with the plaster brace, the other underwent re-operation. Conclusion With stable construct, the internal fixation of transverse patellar body fracture with figure-of-eight tension band wiring combined with cannulated compression screws is less invasive to local soft tissue, optimal on knee functional recovery and fracture union. No complication has occurred, but the long-term clinical result and complication should be followed up for longer time.