Complications Related to Implant Fixation of Patellar Fractures: Comparison of Ring Pins versus Bent K-Wires

Abstract

Patellar fractures are characterized by injuries to the extensor and typically require surgical fixation. Among the methods used for fixation, the most common is the modified AO tension-band wiring technique. However, using this technique, implant migration occurs due to the lack of connections between the K-wires and the tension-band wire, which causes irritation and reduces fracture stability. Recently, new methods for tension-band wiring have been developed in which tension bands lock the K-wires through an attached "ring" to prevent migration. The purpose of this study was to compare the clinical outcomes when either the conventional or novel technique was used for tension-band wiring. This was a retrospective study involving 48 patients who underwent tension-band wiring to correct a patellar fracture. Patients in group 1 ( = 23) were treated between December 2010 and February 2012 using conventional tension-band wiring, while patients in group 2 ( = 25) were treated between March 2012 and May 2014 using the novel ring pin method. Different surgeons performed the operations in the two groups, while all other conditions were consistent. The surgical outcomes were assessed according to the level of implant migration, irritation, and implant removal procedures. All patients in group 2 achieved a union of the patella, while two patients in group 1 did not. These two patients underwent partial patellectomy within 1 year of the initial surgery. Implant migration and removal were significantly more common among patients in group 1 ( = 0.0038 and 0.011, respectively), with the implant removal period being significantly shorter as well ( = 0.005). The novel ring pin method was superior to the conventional method in terms of preventing implant migration, removal, or other secondary operations for the correction of complications.

A retrospective cohort study on prevalence of postoperative complications in comminuted patellar fractures: comparisons among stabilized with Cannulated-Screw, Kirschner-Wire, or Ring-Pin Tension Bands

“…For transverse (C1) and stellate (C2) fractures, previous studies have concluded that CSTB is superior to MKTB, mainly because of fewer occurrences of symptomatic hardware for CSTB fixation, despite comparable failure rates [12,13]. Likewise, in comparison of MKTB and RPTB fixation, one study showed that hardware-associated complications occurred at a decreased rate with RPTB fixation [14].…”

A novel technique of using a miniature plate in combination with tension band wiring to treat comminuted patellar fractures

“…[ 10 ] Despite several technical modifications, management of operative patella fractures continues to be a challenge with poor functional outcomes and high reoperation rates. [ 1 , 11 – 14 ]…”

A novel three-dimensional strapping reduction for the treatment of patellar fractures

“…Finally, about comminuted patellar fractures, there are few solid reduction sites of the patella for towel clamps, and the reduction of patellar fracture cannot be performed effectively. Hence, complications like bone malunion of the patella and incidence of traumatic knee arthritis are commonly reported [8, 9, 28].…”