Comparison of a minimally invasive technique with open tension band wiring for displaced transverse patellar fractures

Chiang, Chao-Ching; Chen, Wei-Ming; Lin, Chi Feng; Chen, Cheng Fong; Huang, Ching-Kuei; Tzeng, Yun-Hsuan; Liu, Chien-Lin

doi:10.1016/j.jcma.2011.05.008

Cited by 30 publications

(47 citation statements)

References 20 publications

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“…This may have been a function of the longer incision and more extensive soft tissue dissection in the open surgery K wire tension band group, and subsequent joint adhesions, which could have had an impact on restoration of knee function. Luna-Pizarro et al [16] and Chiang et al [9] also assessed knee functional recovery postoperatively with other knee function scoring systems; the results showed better scores in patients with patella fractures who received the minimally invasive technique rather than open surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Cable Pin System With Conventional Open Surgery for Transverse Patella Fractures

Mao

Liu

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The cable pin system is an effective device for fixation of transverse patella fractures. However, whether this device provides superior results using a minimally invasive technique instead of conventional open surgery using the K wire tension band method is unclear. Questions/purposes We asked whether a minimally invasive technique would be associated with (1) increased operative time; (2) reduced postoperative pain; (3) faster recovery of ROM; (4) higher knee scores; and (5) reduced complications. Methods Forty patients with displaced transverse fractures of the patella participated in this prospective, randomized, controlled trial. Twenty of these patients underwent a minimally invasive technique and the others had conventional open surgery using K wires. Some data for six of the 20 patients who underwent the minimally invasive technique were published in an earlier prospective, observational trial. At postoperative intervals of 1, 3, 6, 12, and 24 months, pain was measured by VAS scores, active flexion and extension of the knee were measured in degrees by goniometry, and knee function was evaluated using the Böstman clinical grading scale. Results Operative time was longer in the minimally invasive surgery group (54.3 ± 9.8 minutes versus 48.5 ± 6

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Section: Discussionmentioning

confidence: 99%

Comparison of the Cable Pin System With Conventional Open Surgery for Transverse Patella Fractures

Mao

Liu

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…The ends of K-wires stimulated the soft tissue and caused pain, thus affecting performance in early functional exercise of the knee, 26 which was not beneficial to knee joint function. Pain caused by the K-wires can lead to hardware removal, rates of which have been reported to range from 37 to 55% for transverse patellar fractures 27 ; the pain is the main reason for such removal. 28 In contrast, the ASC is a simple internal fixation device that occupies less space and causes only minimal pain when the joint moves in the early phase.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Kirschner Wire Tension Band with a Novel Nickel–Titanium Arched Shape–Memory Alloy Connector in Transverse Patellar Fractures: A Retrospective Study

et al. 2020

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This study aims to compare the clinical outcomes of the nickel–titanium arched shape–memory alloy connector (hereafter referred to as the ASC) and tension band fixation for the treatment of transverse patellar fractures. We retrospectively analyzed a total of 257 patients with transverse patellar fractures who were treated at our emergency orthopaedics department from March 2010 to March 2017. Either an ASC or the Kirschner wire (K-wire) tension band had been used to treat these fractures according to surgeons' experience and preference. We compared operative details, postoperative recovery, and postoperative knee function at 6 months. In terms of surgical duration, blood loss, incision length, length of hospital stay, and postoperative complications, patients in the ASC group showed significantly better results than patients in the K-wire group (p < 0.05). There were no significant differences between the two groups in terms of fracture healing time, knee mobility, and the Boström score at the postoperative 6-month evaluation (p > 0.05). Though, there were similar functional outcomes between two groups whose transverse patellar fractures were different methods, we found that the ASC method was a more reliable, more minimally invasive, and safer treatment option than the tension band wiring method using K-wires, resulting in less tissue damage, shorter surgical duration, shorter length of hospital stay, and fewer complications.

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“…Tension band constructs employ a variety of implants including Kirschner wires, malleable steel wires, cannulated screws, cables, or suture, with no implant or combination of implants proving to be superior to another. 5,9,[18][19][20][21][22][23] Partial patellectomy with advancement of the patellar tendon remains the most common treatment when there is significant comminution of the inferior pole. Currently, there is no well-established method to effectively treat comminuted fractures and those that involve the inferior pole.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

et al. 2018

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Treatment of patella fractures is fraught with complications and historically poor functional outcomes. A fixation method that allows for early mobilization and decreases symptomatic hardware rates will improve knee range of motion, postoperative functional status, and reoperation rates. The purpose of this study was to evaluate the functional outcomes after locked plate osteosynthesis of patella fractures at a Level 1 trauma center. A retrospective case series was conducted of patients who underwent open reduction internal fixation (ORIF) of a patella fracture using a locked mesh plating technique coupled with neutralization of forces on the distal pole of the patella. Twelve patients were evaluated at a mean follow-up of 19 months (range, 6-30) with physical exam, functional outcomes, and radiographs. There were 9 women and 3 men with an average age of 66.1 years (range, 53-75). Radiographic bony union was achieved in all patients by 3-month follow-up. Visual Analog Pain Score averaged 1.7 (median, 1.0; range, 0-8), the mean Knee Outcome Score - Activities of Daily Living Scale was 83.9 (median, 92.1; range, 45.7-100.0), the mean Short Form Musculoskeletal Function Assessment (SMFA) Function Index was 9.9 (median, 3.7; range, 0.7-41.2), and the mean SMFA Bother Index was 11.1 (median, 3.1; range, 0-62.5). The SF-36 Physical Component Score mean was 48.4 ± 8.5 and the SF-36 Mental Component Score mean was 54.1 ± 9.6. No complications developed and there were no reoperations for nonunion, infection, or symptomatic hardware. This study demonstrates that locked plate osteosynthesis for operative patella fractures can reliably achieve bony union with potentially superior functional outcomes as compared with traditional methods. Further studies are needed to evaluate plate fixation for patella fractures, but early results are promising.

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Comparison of a minimally invasive technique with open tension band wiring for displaced transverse patellar fractures

Abstract: POMC method was a reproducibly reliable method, offering better functional outcome, lower incidence of complications, and reoperations, as compared with standard OMATB group for transverse patellar fractures. Nevertheless, it is not recommended for severely comminuted fractures.

Cited by 30 publications

References 20 publications

Comparison of the Cable Pin System With Conventional Open Surgery for Transverse Patella Fractures

Comparison of the Cable Pin System With Conventional Open Surgery for Transverse Patella Fractures

Comparison of the Kirschner Wire Tension Band with a Novel Nickel–Titanium Arched Shape–Memory Alloy Connector in Transverse Patellar Fractures: A Retrospective Study

Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

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