Suture tension-band fixation for patella fractures.

INTRODUCTION

Metallic tension-band wiring with K-wires and cerclage: tension-band wiring (TBW) remains the gold standard for surgery for patella fractures. Re-operation due to symptomatic implants is common. Non-metallic options, such as suture tension-band fixation (STBF), could be a solution. This study aimed to compare an STBF group with a TBW group with respect to complications and implant removal, and to describe the clinical results of the STBF group.

METHODS

All patient files with a patella fracture operated at our institution from 1 January 2016 to 19 August 2019 were reviewed on 1 May 2023. The prospective STBF group included all patients consecutively enrolled between 1 November 2018 and 19 August 2019. The historical TBW group included all patients consecutively enrolled from 1 January 2016 to 31 October 2018.

RESULTS

The mean follow-up for the STBF (n = 24) group was 49 (44-54) months; for the TBW (n = 37) group, 74 (54-88) months. Seven of 23 patients in the STBF group and 19 of 36 in the TBW group had complications (p = 0.11). The STBF group had fewer adverse events than the TBW group, including fewer re-operations for symptomatic implants and fewer early secondary displacements (p = 0.06). No deep infections occurred in the STBF group. At the six-month follow-up, the STBF group had 23/24 unions.

CONCLUSION

STBF was not associated with higher complication rates than TBW fixation.

FUNDING: Department internal funding exclusively.

TRIAL REGISTRATION: Not relevant.