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

Abstract

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

Patellar Fractures

“…More recently, Mao et al 22 obtained better results (due to lower number of problems) with a nonmetallic material.…”

“…In this sense, high-resistance sutures have shown to be an excellent alternative, already in use by other authors, associated both to K-wires or cannulated screws. [17][18][19] The use of high-resistance sutures has shown very good outcomes in previous studies, used alone [20][21][22] or combined with other types of fixation. 9,[17][18][19]23 Even the use of plates has been shown to be useful in patellar fractures.…”

A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application

“…Although there are new techniques such as cannulated screw tension band [11,12] system [13] and patella plate [14], the MTBW is still the most widely accepted surgical method for the treatment of patellar transverse fracture [7]. The MTBW technique is easy to operate on and economical to reduce the burden on patients, and the key of MTBW technique is to keep two k-wires parallel [8,15].…”

Comparison of the outcomes of pull through suturing vs. tension band wiring fixation techniques in the management of patellar fractures

“…Excessive bleeding, increased operative time, and the risk of prolonged anaesthesia time the patient is under. 7,10,15,17,18 Postoperative complications with this method, are mostly implant-related. Other major issues include wire breakage and migration of the wire away from the site leading to implant failure, seen after operative procedure limitations are loss of reduction and implant irritation, with increased rates of subsequent implant removal for symptomatic hardware.…”

“…Other major issues include wire breakage and migration of the wire away from the site leading to implant failure, seen after operative procedure limitations are loss of reduction and implant irritation, with increased rates of subsequent implant removal for symptomatic hardware. 15,17,19 The complications seen with conventional K wire fixation and tension band wiring, several alternative approaches have been described.…”