Five-pointed star lattice sutures for fixation of patella transverse fractures: a clinical study

Tang, Xiaozheng; Ya-yun, Liu; Wu, Hongyan; Gong, Feipeng; Li, Yuxu; Zeng, Hong; Yu, Bao‐Fu

doi:10.1007/s00590-018-2272-1

Cited by 7 publications

(4 citation statements)

References 22 publications

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“… Jirangkul and Kosiyatrakul (2021) demonstrated the stability and efficacy of Fiber Wire in treating TPFs through prospective clinical trials. Tang et al (2018) used double 0-0 polydioxone sutures for braided five-pointed star lattice fixation. However, most of these studies were clinical cases, the follow-up duration was short, and plaster fixation was required for 2–3 weeks to ensure stability.…”

Section: Discussionmentioning

confidence: 99%

Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study

Xiang,

Xiao,

et al. 2024

Front. Bioeng. Biotechnol.

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Objective: Few reports exist on the treatment of transverse patellar fractures (TPFs) using absorbable cannulated screws and high-strength sutures, and most screws and sutures lack good biomechanics and clinical trials. Therefore, this study aimed to demonstrate the biomechanical stability and clinical efficacy of tension-band high-strength sutures combined with absorbable cannulated screws (TBSAS) in treating TPFs (AO/OTA 34 C1).Methods: Finite element models of five internal fixation schemes were established: tension-band wire with K-wire (TBW), TBW with cerclage wire (TBWC), TBW with headless pressure screws (TBWHS), TBW with full-thread screws (TBWFS), and TBSAS. We comprehensively compared the biomechanical characteristics of the TBSAS treatment scheme during knee flexion and extension. Forty-one patients with TPFs in our hospital between January 2020 and August 2022 were retrospectively enrolled and divided into the TBSAS (n = 22) and TBWC (n = 19) groups. Clinical and follow-up outcomes, including operative time, visual analog scale (VAS) pain score, postoperative complications, Bostman score, and final knee range of motion, were compared between both groups.Results: Finite element analysis (FEA) showed that TBWHS and TBWFS achieved the minimum mean fracture interface relative displacement during knee flexion (45°, 0–500 N bending load) and full extension (0°, 0–500 N axial load). There was no significant difference between TBSAS (0.136 mm) and TBWC (0.146 mm) during knee flexion (500 N); however, TBSAS displacement was smaller (0.075 mm) during full extension (500 N). Furthermore, the stress results for the internal fixation and the patella were generally lower when using TBSAS. Retrospective clinical studies showed that the TBSAS group had a shorter operative time, lower VAS pain score at 1 and 2 months postoperatively, better Bostman knee function score at 3 and 9 months postoperatively, and better final knee joint motion than the TBWC group (all p < 0.05). There were five cases (26.3%) of internal fixation stimulation complications in the TBWC group.Conclusion: TBSAS demonstrated excellent safety and effectiveness in treating TPFs. It is sufficient to meet the needs of TPF fixation and early functional exercise and effectively reduces metal internal fixation-induced complications and secondary surgery-induced trauma.

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Section: Discussionmentioning

confidence: 99%

Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study

Xiang,

Xiao,

et al. 2024

Front. Bioeng. Biotechnol.

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“…Sit-to-stand training with visual feedback may represent a useful means of re-establishing balance in such patients. [ 19 , 20 , 24 ]…”

Section: Discussionmentioning

confidence: 99%

Impairment characteristics of static balance and plantar load distribution of patients undergoing tibial cortex transverse distraction for diabetic foot ulcers

Fan

Liu

2022

J Orthop Surg Res

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Objective Tibial cortex transverse distraction (TCTD) has been recently reported for the treatment of diabetic foot ulcers. Herein, we explored the characteristics of the impairments in static balance and plantar load distribution in patients. Methods We performed a retrospective study of 21 patients with diabetic foot ulcers who underwent TCTD, who were regularly followed up for > 1 year after surgery, and 20 healthy individuals (control group). A pressure platform was used to assess the standing balance functions of the lower extremities and the plantar load distribution. Results One patient underwent amputation because of severe infection. In patient group, center of pressure (COP) ellipse sway area, COP path length and angle θ were all larger, compared with those of control group (250.15 ± 98.36 mm2 vs. 135.67 ± 53.21 mm2, 145.15 ± 67.43 mm vs. 78.47 ± 34.15 mm, 39.75 ± 17.61° vs. 22.17 ± 14.15°), with statistically significant differences (P < 0.01). The average plantar load and backfoot load of the unaffected side was significantly larger than that of the affected side (58.4 ± 5.5% vs. 41.6 ± 5.5%, 45.3 ± 6.4% vs. 36.5 ± 5.6%), but they were similar for the two feet of members of the control group. Conclusions Although TCTD may represent an appropriate method for the treatment of diabetic foot ulcers, postoperative impairments in static balance and plantar load distribution remain in the long term. These potential long-term problems should be taken into account in further rehabilitation planning. Type of study/level of evidence: Therapeutic III.

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“…In such cases, the thickness of the needle required to hold the suture and the thickness of the folded suture when passing the suture through the cannulated screws is usually too large for the middle of the screws. As an alternative to polyester suture tension bands through cannulated screws, a variety of fixation techniques using nonabsorbable polyester sutures have been introduced for treating patellar fractures; these techniques provide sufficient stability for early rehabilitation after surgery [ 12 , 30 – 33 ]. To date, there has been no consensus regarding the best fixation technique with nonabsorbable sutures for the treatment of patellar fractures.…”

Section: Discussionmentioning

confidence: 99%

The clinical outcomes and complications of combined fixation with cannulated screws and the modified Pyrford technique for the treatment of transverse patellar fractures: a case series study

Tian

Leng

et al. 2022

BMC Surg

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Background Transverse patellar fractures can be fixed using various techniques. The purpose of the current study was to assess the clinical outcomes and complication rate of a combined fixation technique using cannulated screws and the modified Pyrford technique with nonabsorbable polyester sutures. Methods and patients Between January 2015 and February 2021, 26 transverse patellar fractures were fixed with this combined technique. Preoperative data were collected from patients with transverse patellar fractures who were followed up for at least 12 months. At each follow-up visit, plain radiographs were taken. At the 12-month postoperative follow-up, range of motion of the affected knee joint and clinical outcomes, as evaluated by the Bostman scoring system, were recorded. Results The average Bostman score at the 12-month postoperative follow-up was 28.3 ± 1.5. Furthermore, the average extension and flexion of the knee joint were 1.2 ± 2.1 and 125.6 ± 6.7 degrees, respectively. One patient experienced delayed bone union and one experienced superficial wound infection. There were no other postoperative complications. One patient required removal of the device for social-psychological reasons. Conclusions The combined fixation technique with cannulated screws and the modified Pyrford technique with suture materials produced excellent clinical outcomes and a low rate of complications in the treatment of transverse patellar fractures.

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Five-pointed star lattice sutures for fixation of patella transverse fractures: a clinical study

Abstract: Level IV case series.

Cited by 7 publications

References 22 publications

Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study

Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study

Impairment characteristics of static balance and plantar load distribution of patients undergoing tibial cortex transverse distraction for diabetic foot ulcers

The clinical outcomes and complications of combined fixation with cannulated screws and the modified Pyrford technique for the treatment of transverse patellar fractures: a case series study

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