Comparative study of twin-perforated orthopedic pin with metal cable versus ao tension band wiring in patellar fracture management.

OBJECTIVE

This study aimed to evaluate the clinical effectiveness and biomechanical properties of perforated orthopedic bone pins in conjunction with metal wire for the management of large fragment patella fractures.

METHODS

This study involved 45 patients with large fragment patella fractures who were treated between January 2017 and December 2022. The patients were assigned to either the observation or control group based on the adopted therapeutic modality. The observation group (n = 23) underwent open reduction and internal fixation utilizing perforated orthopedic bone pins and metal wire. The control group (n = 22) was treated by open reduction and internal fixation using AO Kirschner wire tension bands. The comparative analysis between the groups included the following metrics: operation duration, bone union time, knee joint functionality, incidence of complications, and stability of fixation.

RESULTS

The follow-up period ranged from 6-20 months. Twenty-two patients in the observation group achieved excellent outcomes, and one achieved a good outcome, resulting in a combined excellent and good outcome rate of 100%. The distribution of outcomes in the control group was 18 excellent, three good, and one fair, resulting in a combined excellent and good outcome rate of 95.5%. The observation group, treated with perforated orthopedic bone pins and metal wire, demonstrated superior results in terms of lower complication rates and enhanced fixation stability compared to the control group, which was treated with AO Kirschner wire tension bands. Biomechanical testing revealed the twin-perforated pin group withstood 42% greater peak load (p < 0.05) and exhibited 31% less displacement under cyclic loading compared to controls.

CONCLUSION

Both treatment modalities-perforated orthopedic bone pins with metal wire and AO Kirschner wire tension bands-were effective in managing large fragment patella fractures. However, the former treatment modality demonstrated superior overall effectiveness, reduced complication rates, and improved stability of fixation, making it a preferable choice for broader clinical adoption.