3D reduction combined with the modified Kirschner-wire tension band for the treatment of comminuted patella fracture.

Abstract

A novel 3D reduction method combined with a modified Kirschner-wire tension band (3D MKTB) fixation method to treat comminuted patella fractures was introduced in this study. This study aims to evaluate the effectiveness and practicality of this novel technology. This study is a retrospective case series study. Twenty-eight patients with closed comminuted patella fractures were treated with the novel 3D MKTB fixation method. Radiographs of the knee were obtained at the routine follow-up to assess fracture healing and widening of the articular step-off. Clinical outcomes including the degree of pain on a visual analogue scale (VAS), range of motion, Lysholm, and Bostman grading scales were measured at the last follow-up. The mean follow-up was 39.8 ± 10.5 (range 26-62) months. All patients had bony union at a mean of 11.4 ± 1.4 (range 9-14weeks) weeks based on X-ray. No patient had evidence of internal fixation failure. Only two patients suffered from surgical complication. One patient suffered from postoperative superficial infection, and one patient suffered from internal fixation irritation. Articular step-off larger than 2mm was not seen in any cases. The average VAS-related pain score was 0.5 ± 0.5 (range 0-1) points. The average range of motion was 0-138.6° ± 11.9° (range 90°-155°), all patients had full knee extension. The mean Lysholm and Bostman scores were 92.9 ± 3.5 (range 86-100 points) points and 28.5 ± 1.3 (range 24-30 points) points, respectively. The novel 3D reduction technique combined with the modified Kirschner-wire tension band technique is an effective, safe, and simple treatment option for comminuted patella fractures. IV.