Figure of eight suturing technique with fiber wire for patella fracture: a novel approach

Abstract

Modified tension band wiring (TBW) is the most commonly used technique for the management of patella fractures. However, all patella fractures are not-amenable to TBW. Tension band wiring, inter-fragmentary screw fixation, and the combination of cerclage wiring and screw fixation are used for internal fixation of these fractures. Surgical treatment is recommended for fractures that either disrupt the extensor mechanism or have greater than 2 to 3 mm of step-off and greater than 1 to 4 mm of displacement. In this series, we present ten cases managed with open reduction and internal fixation with figure of eight suturing technique using fiber wire. This series included ten patients with fractured patella and managed with open reduction and internal fixation with Tension band wiring with fiber wire. Patient demographics, fracture type, time to union, functional outcome, and complications were recorded. Patients were followed up for minimum of 6 months. All fractures went on to unite with average fracture healing time of 13.8 weeks. Mean Lysholm score and Bostman score were 85 and 27 respectively. Nine patients had excellent to good outcomes. One patient had poor outcome because of knee stiffness. Open reduction and internal fixation with figure of eight suturing technique using fiber wire are an efficient method for the management of severely comminuted and multi-fragmentary patella fractures with minimum complications.