Efficacy of K-wire tension band fixation compared with other alternatives for patella fractures: a meta-analysis

Zhang, Yinwang; Xu, Zhen; Zhong, Wuxue; Liu, Fuhai; Tang, Jie

doi:10.1186/s13018-018-0919-6

Cited by 27 publications

(26 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Generally speaking several surgical treatment options are available according to the fracture type using the AO classification. Open or closed fixation using tension band wiring with its modifications as well established techniques for transverse fractures of the patella are widely used [17][18][19]. Dy et al reported in their meta-analysis about several complications of tension band wiring resulting in a less functional outcome and high revision rates in up to one-third of all patients including loss of reduction and secondary dislocation, implant failure or implant discomfort [20,21].…”

Section: Discussionmentioning

confidence: 99%

Influence of patella height after patella fracture on clinical outcome: a 13-year period

Pesch

Zyskowski

Greve

et al. 2021

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Introduction The incidence of patella fracture is statistically low (0.5–1.5%) compared to other fractures of the extremities [Patella fractures 76(10):987–997, 2005]. In the latter research, patella fractures if treated surgically present an overall inferior functional outcome. Little is known about the influence of the postoperative patella height on the clinical outcome. Therefore, the aim of our study was to analyse the influence of the patella height on the patients’ functional outcome after surgery. Methods In this retrospective study the in-house trauma register of our level I University trauma center was screened for patients suffering patella fractures treated surgically. Patella height of the same patients was evaluated on lateral X-rays using the Insall–Salvati Ratio (ISR). The patients’ X-rays were analyzed at two time points for the ISR, whereas group A presents ISR data right after surgery and group B data at the latest follow up (minimum 6 weeks). The change of mean ISR at both time points was tested for significance. The functional outcome was measured by the “Munich Knee Questionaire” (MKQ). These MKQ results of different patella heights and fracture types were compared. Results The screening of our in-house trauma register revealed 375 patients between the years 2003 and 2016. Out of these 54 patients (34f, 20 m) were enrolled. In detail the follow-up time for ISR between group A and B accounted for a mean of 503.8 ± 655.7 days. The MKQ was assessed at a mean of 1367.0 ± 1042.8 days after surgery. According to the AO-classification 10% AO.34 type B and 90% AO.34 type C fractures were found. Group A showed in 9.1% a patella baja and in 27.3% a patella alta compared to group B presenting 20.0% patella baja and 14.5% patella alta. There was no significant difference in functional outcome referring to the MKQ in patella alta (MKQ 69.0% ± 18.2) or baja (MKQ 67.1% ± 17.9) (p = 0.9). No significant functional difference between AO34.type B (MKQ 74.5% ± 11.0) and AO34.type C fractures (MKQ 64.0% ± 15.0) resulted (p = 0.1). Conclusion Our results demonstrate that different postoperative patella heights apparently do not influence the functional outcome in the short follow-up.

show abstract

Section: Discussionmentioning

confidence: 99%

Influence of patella height after patella fracture on clinical outcome: a 13-year period

Pesch

Zyskowski

Greve

et al. 2021

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

show abstract

“…Tension band with cannulated screw had a better curative effect on patella fracture, lower complication rate, and higher quality of life of patients. A meta-analysis report showed that there was no difference in the success rate of operation, operation time, fracture healing time, and the number of infections between the cannulated screw and Kirschner wire tension band in treating patella fracture, but cannulated screw tension band was superior to Kirschner wire tension band in reducing the incidence of complications [ 20 ]. In the internal fixation of patella fracture, biodegradable implants were not as effective as metal implants in the treatment of displaced patella fracture, but implant stimulation was the main reason for the second operation, and the removal rate of symptomatic implants after treatment with cannulated screw tension band was low (8%) [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Therapeutic Effects of Tension Band with Cannulated Screw and Tension Band with Kirschner Wire on Patella Fracture

Liu¹,

Ren

ChunYan³

et al. 2020

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Background. Patella fracture accounts for 1% of bone injury, of which anatomical reduction is of great significance to the recovery. Tension band with cannulated screw and Kirschner wire is commonly used methods for the treatment of displaced patella fracture. However, there is still some controversy on the clinical efficacy of the two treatment methods. Objective. This study aimed at comparing the therapeutic effects of the cannulated screw and Kirschner wire tension bands on patella fracture and at providing more data basis for clinical selection of treatment methods for patella fracture. Methods. Altogether, 146 patients with displaced patella fracture admitted to our hospital from March 2016 to February 2018 were selected and divided into two groups according to the different treatment methods. Among them, 71 patients received tension band with a cannulated screw (TBWCS group) and 75 patients received tension band with Kirschner wire (TBWKW group). Two groups of patients were compared in terms of surgical treatment effect after one year of treatment, complications within six months after the operation and operation-related indexes. The pain visual analogue scale (VAS) score, knee flexion degree, Lysholm score, and Bostman score were recorded at 1, 3, 6, and 12 months after operation, and the activity of daily living scale (ADL) score was evaluated at the last follow-up. Results. During the operation of patella fracture patients, the intraoperative blood loss, hospitalization time, and knee flexion loss of patients in TBWCS group were less than those in the TBWKW group (P<0.05), the starting time of postoperative functional exercise was earlier than that of patients in TBWKW group (P<0.05), and the incidence rate of secondary operation was lower than that of patients in the TBWKW group (P<0.05), but there was no statistical difference in the operation time, incision length, and postoperative fracture gap between the two groups. The results of curative effect analysis showed that the knee flexion, Lysholm score, and Bostman score of patients treated with tension band with cannulated screw were higher than those treated with Kirschner wire (P<0.05), and VAS score was lower. Tension band with cannulated screw had a better curative effect on patella fracture (P<0.05), lower complication rate (P<0.05), and higher quality of life of patients (P<0.05). Conclusion. Tension band with cannulated screw has a good curative effect on patella fracture, low incidence of complications, early start of postoperative functional exercise, and high quality of life.

show abstract

“…12,23,25 Although there are some complications associated with migration of K-wire, TBWKW has been shown sufficient stability for a bone union. 26 In results of this study, TBWKW and TBWRP were proven enough clinical stability.…”

Section: Discussionmentioning

confidence: 60%

“…Although the TBWRP group showed similar fixation strength to TBWKW group, the clinical results of TBWRP are reported to be superior to TBWKW because of stationary implant. 26 Kim et al 14 reported TBWRP to have 100% union rate with 0% pin migration with pin removal rate of 8.3%, which is lower than the previously reported outcome of MTBW. Kyung et al 15 also reported 100% union rate and migration rate, which was statistically superior to TBWKW technique.…”

Section: Discussionmentioning

confidence: 75%

Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins

Lee

et al. 2019

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Purpose: The purpose of this study is to compare biomechanical characteristics of tension band wiring using Kirschner wires (TBWKW), cannulated screws (TBWCS), and ring pins (TBWRP) for transverse fracture of the patella. Methods: A total of 48 polyurethane synthetic patellae were biomechanically tested. All patellae were osteotomized to create a transverse fracture. Each TBWKW, TBWCS, and TBWRP fixed 16 broken patellae. A specially designed fixation board simulated a knee with 90° flexion. Ten static tests and six dynamic tests were performed on each method. The static test is measuring maximum strength ( N) during traction until breakage of the fixation. The dynamic test consisted of measuring the fracture gap (mm) after 10,000 repetitive loading cycles between 100 N and 300 N that simulated actual daily activity. A gap of 2 mm or more was defined as a failure in both tests. Result: The failure load was 438.6 ± 138.6 N, 422.2 ± 72.7 N, and 1106.8 ± 230.3 N for TBWKW, TBWRP, and TBWCS, respectively. TBWCS showed a statistically significant difference compared to TBWKW and TBWRP in the static test ( p < 0.001). All the groups had no failure in the dynamic test. The mean fracture gap after completion of the dynamic test was 0.3267 ± 0.3395 mm, 0.2938 ± 0.2165 mm, and 0.0360 ± 0.0570 mm for TBWKW, TBWRP, and TBWCS, respectively ( p = 0.044). The mean values in the dynamic test showed no statistical difference. There was a significant difference between TBWRP and TBWCS ( p = 0.009), but others showed no difference with statistical significance. Conclusion: All three methods have sufficient stability at a daily activity. TBWCS showed a better failure load compared with TBWKW and TBWRP. TBWRP showed compatible mechanical characteristics with traditional tension band wiring. TBWRP could be an alternative method for TBWKW.

show abstract

Efficacy of K-wire tension band fixation compared with other alternatives for patella fractures: a meta-analysis

Cited by 27 publications

References 21 publications

Influence of patella height after patella fracture on clinical outcome: a 13-year period

Influence of patella height after patella fracture on clinical outcome: a 13-year period

Comparison of the Therapeutic Effects of Tension Band with Cannulated Screw and Tension Band with Kirschner Wire on Patella Fracture

Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins

Contact Info

Product

Resources

About