Abstract
BackgroundMid-pole patellar fractures are typically fixed with metal implants in the conventional “11-8” tension band construct. However, this technique is fraught with numerous implant-related complications. The aim of this study is to evaluate the union rate following “all-suture” fixation of mid-pole patellar fractures.MethodsWe retrospectively evaluated a consecutive case series of patients with displaced mid-pole patella fractures treated with “all-suture” fixation in our institution. Fifteen cases were available for this study. The average age was 61.5 years. Clinical and radiological outcomes were evaluated. Union time, complications, and revision rate were recorded. The minimum follow-up was one year.ResultsThere were eight males and seven females, with a mean age of 61.5 ± 13.3 years. Fourteen out of 15 cases (93.3%) achieved radiographic union at 12 weeks postoperatively. The average time to radiographic union was 8.0 ± 2.7 weeks. Five cases (33.3%) had an increase in the fracture gap (>2 mm) at around four to six weeks postoperatively. Four of these cases had an eventual union, whereas one patient had fibrous non-union. There was one case of superficial surgical site infection and one case of infected hematoma. None of the patients required revision surgery.Conclusion“All-suture” fixation of mid-pole transverse patellar fractures is a safe and viable alternative to the conventional “11-8” tension band constructs with metal implants, with good union time, rates, and added benefits of not requiring additional surgery for implant removal.
Highlights
Mid-pole patellar fractures are a relatively common injury and typically require surgical fixation [1,2]
The present study shows that the “all-suture” fixation technique is a safe and viable alternative to the conventional “11-8” tension band constructs, with good union time and rates
The tension band wiring technique has been the preferred choice of procedure for the treatment of displaced mid-pole patellar fractures
Summary
Mid-pole patellar fractures are a relatively common injury and typically require surgical fixation [1,2]. The surgical treatment of mid-pole patellar fractures involves various surgical techniques, most of which involve the use of metallic implants such as Kirschner (K-wires) and cerclage wires [2,4,5]. While the union rate of the "11-8" tension band constructs approaches 87.5%, numerous complications exist [7]. Mid-pole patellar fractures are typically fixed with metal implants in the conventional “11-8” tension band construct. This technique is fraught with numerous implant-related complications. The aim of this study is to evaluate the union rate following “all-suture” fixation of mid-pole patellar fractures
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