FiberWire tension band for patellar fractures

Abstract

BackgroundSymptomatic hardware represents the most frequent complication reported following surgical treatment of patellar fracture. For this reason, some authors suggested using nonabsorbable sutures to fix the fracture with various techniques. The aim of this study was to evaluate clinical and radiological results of patients treated following a modified Pyriford technique using a FiberWire suture (Arthrex, Naples, FL, USA).Materials and methodsWe retrospectively evaluated a case series of seventeen patients with displaced patellar fractures treated by open reduction and internal fixation with a modified tension band using FiberWire sutures. Clinical and radiological outcome were evaluated. Union time, complications, and reoperation rate were observed and recorded.ResultsAll fractures healed (time to union 9.2 ± 2 weeks), and no fixation failure was observed. Slight losses of reduction (<4 mm) were noted in two patients at 4 weeks postoperatively. The average Lysholm and Bostman scores at the final follow-up were 91 ± 5.7 (range 83–100) and 28.3 ± 1.6 (range 26–30), respectively.ConclusionModified tension band using FiberWire sutures showed satisfactory clinical results, with a low incidence of complications and reoperations. FiberWire tension bands could be used in place of metal-wire tension bands to treat patellar fracture, reducing the rate of symptomatic hardware.Level of evidence4

Percutaneous Tension-Band Suture Technique for Distal Patella Fracture Fixation

“…We describe a successful treatment of a transverse distal patella fracture utilizing a novel percutaneous application of a previously reported suture tension band technique using #5 FiberWire [10]. Immediate mobilization was started after surgery.…”

“…After a thorough discussion of non-operative verses operative treatment, the patient and her parents elected to move forward with fixation of the fracture to promote healing, allow early mobilization and minimize the risk of displacement. Because of minimal displacement, it was elected to move forward with a previously described suture tension band technique using #5 FiberWire [10]. The unique aspect of this case is the percutaneous placement of this figure-of-8, tension band suture fixation ( Figure 2).…”

“…For this reason, some have advocated the use of nonabsorbable sutures such as braided polyester, lowering the rate of revision surgery secondary to symptomatic hardware [3,[10][11][12][13][14]. Studied suture material has included number 5 Ethibond (Ethicon, Somerville, NJ, USA), number 5 Ti-Cron (Davis and Geck, Gosport, Hampshire, UK) and number 5 FiberWire sutures (Arthrex, Naples, FL, USA).…”

“…Furthermore, it was observed that unlike stainless steel, FiberWire maintained its initial stiffness until failure [15]. A recent study demonstrated that a modified tension band using FiberWire sutures showed satisfactory clinical results with low incidence of complications and reoperations [10]. The usual surgical intervention is carried out through an extensile skin incision with a substantial soft tissues dissection sufficient for fracture and joint-surface visualization.…”

Vertical and figure of eight fibre wiring for patella fractures

“…Non absorbable braided sutures are been used by many authors in various ways to avoid these hardware problems [6][7][8][9][10][11]18] . Internal fixation of patella with vertical wiring augmented with Krackow sutures are also being done for inferior pole patella fractures [24] . Fibre wires being stronger are now being used instead of braided nonabsorbable sutures.…”