Abstract
BackgroundEFECE systems are newly defined internal fixation systems, which are suitable for patella fracture fixation. The aim of this study was to compare the fixation strength of EFECE Systems with tension band wiring for transverse patellar fracture simulation on fresh frozen cadaver models.MethodsQuadriceps tendon-patella-patellar tendon (QT-P-PT) complex was prepared from human cadavers. After simulation of a transverse patella fracture, in group 1, 5 patella were fixed with a pair of 1.2 mm EFECE wires and 4 EFECE devices. In group 2, 5 patella were fixed with a pair of 1.2 mm Kirschner wires (K-wire) and a cerclage wire according to the tension band technique.Using a testing device with custom-made jaws, increasing distraction force was applied to these QT-P-PT complexes. Extension of these complexes with the distraction forces was observed. The maximum distraction force and the elongation during maximum force were evaluated.ResultsAfter 5 experiments with the EFECE systems, there was no EFECE wire breakage or EFECE wire-EFECE device catching failure. The median maximum force was 740 N (720-810 N). During maximum distraction force the median extension was 2.5 mm (1.6-2.5 mm). After 5 experiments with the tension band technique, there was no K-wire breakage. The median maximum force was 330 N (240-510 N). During this maximum distraction force the median extension was 3.4 mm (2.2-3.8 mm).ConclusionsBased on the biomechanical advantages, patella fracture treatment with EFECE systems may constitute a reasonable alternative in the treatment of patella fractures.
Highlights
The patella is the largest sesamoid bone in the human body and fractures of this bone account for 1% of all skeletal system fractures [1]
In group 2, 5 patella were fixed with a pair of 1.2 mm Kirschner wires (K-wire) and a cerclage wire according to the tension band technique
The maximum load level of the EFECE system fixation was determined to be more than 2 times greater than that of tension band wiring (Table 1, P = 0.008)
Summary
The patella is the largest sesamoid bone in the human body and fractures of this bone account for 1% of all skeletal system fractures [1]. Conservative treatment is indicated to fractures with minimal displacement and those with no articular surface incongruency. The tension band technique, defined by Müller et al in 1979, became the standard technique for patella fracture fixation [4]. In this open fixation technique, 2 parallel Kirschner wires (K-wire) and a cerclage wire compress the fracture line and cause compression of the articular surface with distraction forces. EFECE systems are newly defined and patented, internal fixation implants, which have the indication scale for patella fractures. The aim of this study was to compare the fixation strength of EFECE Systems with tension band wiring for transverse patellar fracture simulation on fresh frozen cadaver models
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