Cannulated screw with modified augmented c-wire fixation is effective for various types of complex patellar fractures: An evidence-based case series.

INTRODUCTION

The current standard surgical approach for treating displaced transverse or simple patellar fractures is the tension band wiring technique with Kirschner wires. The use of cannulated screw with modified augmented cerclage wire (c-wire) has a potential to be an alternative use for this fixation especially in complex cases.

PRESENTATION OF CASE: This case series reported four patients with patellar fractures treated with cannulated screws and modified augmented c-wire with a follow-up for at least twelve months of follow-up. There were two cases of two-part transverse fractures, one case of non-union, and one case of comminuted fracture. Most patients had union, with variable functional outcomes, no failures of reduction, and no short term complication were observed.

DISCUSSION: Biomechanical studies have shown the superiority of the cannulated screw with modified augmented c-wire fixation to k-wire fixation in transverse and comminuted fracture. Cannulated screw fixation also has a lower rate of implant removal and higher functional outcome compared to K-wire fixation.

CONCLUSION

Cannulated screws combined with modified augmented c-wire are a viable option for various types of patellar fractures. This method can be effectively used for transverse, comminuted, and non-union patellar fractures.