Does the Cannulated Screw Tension Band Improve Quadriceps Muscle Strength, Atrophy, Implant Irritation and Functional Results in Patella Fractures Compared to the Kirschner Wire Tension Band?

Abstract

Background:We aimed to evaluate the effects of the cannulated screw tension band and Kirschner (K) wire tension band methods on quadriceps muscle strength and atrophy, implant irritation and functional results in the treatment of patella fractures. Materials and Methods:In this study, 70 patients with a diagnosis of patella fracture, who were operated in our clinic between January 2015 and May 2019, were retrospectively evaluated. Patients were operated in two separate groups: in group 1, 21 patients were fitted with a cannulated screw tension band, and in group 2, 49 patients were treated by the K wire tension band method. The Lysholm score was used for clinical evaluation. The loss of extensor muscle strength in the patients was measured with an analogue dynamometer.Results: There was no difference in the effect of two different techniques, age, gender, and fracture type on the duration of fracture union in the surgical treatment of patella fractures (p>0.05). Clinically, there was no difference in Lysholm score between the two groups (p>0.05). Knee extensor muscle strength decreased in both groups compared to the healthy side (p<0.05), and the two groups were similar (p>0.05). We found that the thigh diameter was decreased compared to the healthy side in patients who underwent surgery for patella fracture (p=0.001). There was no difference in thigh diameter difference between the two groups (p>0.05). Conclusion:With the two different techniques, quadriceps muscle strength, atrophy and clinical results were similar. In the K-wire tension band method, more implant removal was required due to irritation.

Metallic Implants for Patellar Fracture Fixation: A Systematic Review

“…Healing time: Patients undergoing TBCS had statistically more favorable outcomes than those treated by TBKW with a very highly significant difference (P<0.00001) (OR = -0.36, 95% CI: (-0.48, -0.25)). The shortest period (mean 1.72 months)was related to the TBCS group in the Hancerli study (22) . the longest period for union (mean3.3 ±0.7 months) was related to the TBKW group in the Liu study (figure 3) (23) Complications and Hardware Failure; Non-favorable outcomes were reported in all studies.…”