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

Abstract

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.

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

“…The tension band technique converts the patellar surface tension generated by the extensor muscle during knee flexion into the axial compression force of the patellar fracture surface, thereby promoting bone healing and demonstrating good efficacy ( Jia et al, 2022 ). However, owing to the specific anatomic location of the patella, it is associated with a higher overall complication rate (approximately 52%) ( Li et al, 2022 ), including Kirschner needle displacement, tension band breakage, symptomatic hardware, and infection ( Lee et al, 2021 ; Trinchese et al, 2021 ). The modified regimen of titanium-cannulated screws may have better biomechanical characteristics and stability and can provide a direct compression force between the fracture fragments.…”