Clinical application of cannulated screws tension band and cerclage fixation for displaced patellar fractures based on fracture morphological classification.

INTRODUCTION

Numerous surgical strategies are available for displaced patellar fractures, yet a universally accepted treatment standard remains lacking. Internal fixation constructed on the tension-band principle constitutes the primary treatment modality for such injuries. This study aimed to evaluate the clinical outcomes of two cannulated screw tension-band fixation techniques combined with cerclage fixation for displaced patellar fractures.

METHODS

A retrospective study was conducted on patients with displaced patellar fractures. The patients were divided into the group I treated with modified cross cannulated screws tension band and cerclage fixation, and the group II treated with parallel cannulated screws tension band and cerclage fixation. Baseline data, intraoperative variables, fracture healing status, complications, and Böstman scores were compared between the two groups to assess clinical efficacy.

RESULTS

All patients in both groups were followed up for 2 years. Two patients in Group II presented with anterior patellar discomfort, whereas no adverse events were recorded in Group I. Bony union was achieved in all cases of both groups. There were no significant differences in incision length, hospital stay, fracture healing time, or complications between the two groups (P > 0.05). The operation time, intraoperative blood loss, and fluoroscopy times in the group I were higher than those in the group II (P < 0.05). The Böstman scores of both groups at 6 months after surgery were significantly lower than those before surgery (P < 0.05), and there was no statistically difference between the two groups at 6 months after surgery (P > 0.05).

CONCLUSIONS

Both cannulated screws tension band combined with cerclage fixation can achieve good clinical efficacy in the treatment of patellar fractures. The operation time, intraoperative blood loss, and fluoroscopy times in the cross cannulated screws tension band group are higher than those in the parallel cannulated screws tension band group. In clinical practice, the cross screw insertion method can be considered when fracture comminution makes parallel screw placement difficult.