Patella fractures treated with cannulated lag screws and fiberwire® have a high union rate and low rate of implant removal

Busel, Gennadiy; Barrick, Brett; Auston, Darryl A.; Achor, Kyle; Watson, David; Maxson, Ben; Infante, Anthony; Sanders, Roy; Mir, Hassan R.

doi:10.1016/j.injury.2019.10.002

Cited by 19 publications

(20 citation statements)

References 15 publications

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“…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 ]. Tan et al [ 22 ] also reported in the study that the cannulated screw tension band had a better curative effect in the treatment of patella fracture compared with the Kirschner wire tension band, and it reduced the occurrence of pain caused by implants and implant loosening.…”

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

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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.

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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

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“…Related studies using FiberWire in transverse patella fracture fixation show a low symptomatic hardware removal [ 9 – 11 ]. Busel et al reported 8% symptomatic hardware removal after patella fixation using cannulated lag screws and FiberWire [ 10 ]. Camarda et al reported a retrospective case series using only No.5 FiberWire tension band.…”

Section: Discussionmentioning

confidence: 99%

“…Although no metal implant was retained, its principle was not the actual modified tension band fixation due to the lack of parallel longitudinal intra-osseous fixation. Other related studies reported using the modified tension band technique with FiberWire and retained metallic parallel implants including K-wires [ 19 ] and cannulated lag screws [ 10 ]. Although a low rate of symptomatic hardware removal was reported, the retained metal hardware may irritate soft tissue or implant migrations and encounter breakage.…”

Section: Discussionmentioning

confidence: 99%

“…Although the strength of FiberWire is weaker than that of stainless steel wire, the maximum tensile force is more potent [13]. Related studies using FiberWire in transverse patella fracture fixation show a low symptomatic hardware removal [9][10][11]. Busel et al reported 8% symptomatic hardware removal after patella fixation using cannulated lag screws and FiberWire [10].…”

Section: Discussionmentioning

confidence: 99%

“…Although the common use and sufficient stability of standard tension band wiring, symptomatic implants, and skin complications such as infection have been reported in the literature, removal of troublesome material is needed in up to 60% of these patients [3,6,7]. An alternative material to replace the metal wire is nonabsorbable suture (FiberWire/Ethibond), producing similar outcomes with a lower complication rate [8][9][10][11] and comparable strength in a biomechanical study [12]. We present a new surgical technique of modified tension band wiring of transverse patella fractures.…”

Section: Introductionmentioning

confidence: 99%

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Abstaining from symptomatic implants of modified tension band wiring by nonabsorbable suture fixation for transverse patella fractures

Jirangkul

Kosiyatrakul

2021

J Orthop Surg Res

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Background Modified tension band fixation has become commonly used for transverse patella fractures. The conventional stainless steel wire provides sufficient stability but may be associated with complications. Objective The study aimed to evaluate the effectiveness of a new modified tension band fixation technique for transverse patella fractures using a nonabsorbable suture. Material and methods We present the result of a prospective series using a nonabsorbable suture (FiberWire) for transverse patella fractures. The mean follow-up period totaled 12 months. A total of 16 patients were evaluated by radiographic and clinical review. The postoperative clinical evaluation employed Lysholm and Böstman scores. Result All clinical results on follow-up were good to excellent. Minimal intra-articular joint stepping and further fracture displacement were recorded. No patient needed re-operation, and functional outcomes of the knee were satisfactory. No significant differences were found between the injured and contralateral knee range of motion. No symptomatic implants and skin complications were noted, and all fractures were completed heal within 15 weeks. Conclusion FiberWire provided sufficient stability and reduced postoperative complications. The results proved appropriate, and the technique has merit, as it obviates the need for re-operation.

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Epidemiology, classification and treatment of patella fractures: an observational study of 3194 fractures from the Swedish Fracture Register

Kruse

Wolf

Mukka

et al. 2022

Eur J Trauma Emerg Surg

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Background Basic epidemiological data on patella fractures derived from large nationwide and multicenter studies are scarce. This observational register study describes patient epidemiology, fracture classification and treatment of patella fractures in adults in a Swedish population. Methods We conducted an observational study on data derived from the Swedish Fracture Register (SFR) on all patella fractures classified as non-periprosthetic and non-pathological, registered between 2014 and 2018 in individuals aged ≥ 18years. Epidemiological data on sex, age, side, seasonal variation, trauma mechanism, fracture classification (according to AO/OTA), and treatment were analyzed. Results 3194 patella fractures were analyzed, occurring at a median age of 67 (range 19–100) years. 64% of all patients were female. Most fractures were caused by low-energy trauma, with 70% due to falling from a standing height. 1796 (56%) of the fractures were transverse compared to 845 (26%) vertical fractures. Most fractures (N=2148, 67%) were treated non-operatively. Operative treatment consisted mainly of Tension Band Wiring (TBW) performed in 774 (24%) patients. Conclusions Patella fractures mainly occur in elderly women (> 65 years), commonly caused by low-energy trauma. The main treatment is non-operative (67%), except for transverse (AO/OTA C3) fractures. TBW remains the most used operative treatment of choice. These results may help health care providers, researchers and clinicians better understand the panorama of patella fractures in Sweden.

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Patella fractures treated with cannulated lag screws and fiberwire® have a high union rate and low rate of implant removal

Cited by 19 publications

References 15 publications

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

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

Abstaining from symptomatic implants of modified tension band wiring by nonabsorbable suture fixation for transverse patella fractures

Epidemiology, classification and treatment of patella fractures: an observational study of 3194 fractures from the Swedish Fracture Register

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