Early clinical outcome for transverse patellar fracture treated by tension band with 2 k-wires or 2 cannulated screws

Abstract

Objectives: The goals of surgical treatment are to reestablish continuity of the extensor mechanism and to restore a smooth articular surface using stable internal fixation to permit early knee motion.
 Methods: a comparative prospective study was done in Baghdad during the period from January 2016 till November 2019, we evaluated 50 patients with closed displaced (more than 3 mm) transverse patellar fracture, but only 44 patients complete the follow up divided into two groups (group 1) 22 patients was operatively treated by k-wires with tension band and (group 2) 22 patients was operatively treated by 2 cannulated screws with tension band. Both groups were evaluated for first 6 months after operation We evaluated the patients radiological, clinically and functionally every 2 months period by using the modified hospital for special surgery (HSS) knee score based on 4 standards clinical outcomes in which pain assessed by visual analog scale (vas), range of motion by goniometry, displacement on x ray, and quadriceps strength.
 Results: in group1 male were (16 patients) 72% and female were (6 patients) 28%.in group2 male were(14patients) 64% and female were (8patients) 36% with a mean age of 32 year (20-55)year in group1 and 34year(26-57)year in group 2.The VAS scores showed that the group2 had lower pain scores and better
 range of motion (ROM) compared to group1. quadriceps strenghth more than 75% in group 2 and no fracture displacement as compared with group 1excellent and good results were (63%) in group1and (81%) in group 2.Poor and fair results were (36%) in group1 and (18%) in group2.
 Conclusion: fixation of patellar fracture(closed, transverse, in adult) by 2 cannulated screws and tension band is superior to tension band with 2 k-wires with less complications.