Hybrid separate vertical wiring plus tension-band fixation for inferior-pole patellar fractures with articular-body extension: a consecutive series of 14 cases.

PURPOSE: This study evaluates the clinical and radiological outcomes of a hybrid surgical strategy combining separate vertical wiring (SVW) with tension-band wiring (TBW) for complex patellar fractures involving both inferior-pole comminution and articular-body extension.

METHODS

Fourteen consecutive patients treated with the hybrid SVW+TBW technique were retrospectively reviewed. Outcomes included radiographic union, patellar height (Insall–Salvati ratio), and functional recovery (Lysholm scores and ROM) at serial follow-ups up to 12 months.

RESULTS

All fractures achieved bony union at a median of 68 days. The median Lysholm score significantly improved from34.0 at 6 weeks to 89.0 at 1 year (p = 0.001), with a notable gain following hardware removal. All patellar height measurements remained within the physiological range. No major complications, such as loss of reduction or hardware failure, occurred.

CONCLUSIONS

The hybrid SVW+TBW construct may provide a practical and bone-preserving option for managing complex patellar fractures. This technique achieved reliable union and stable fixation in this series, though further comparative studies are needed to establish its role relative to plate fixation.