Depeng Meng1, Peng Xu1, Di Shen1, Yu Chen1, Chengdong Zhu2, Chunlin Hou1, Haodong Lin3, Yueping Ouyang4. 1. Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China. 2. Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China; Department of Orthopedics, The People's Hospital of Yizheng City, Jiangsu, PR China. 3. Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China. Electronic address: linhaodong1978@smmu.edu.cn. 4. Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China. Electronic address: Oyaopin@aliyun.com.
Abstract
BACKGROUND: Tension bands structures are widely used to treat transverse patellar fractures. However, many implants-related complications have been reported. The purpose of this study is to evaluate effects and compare complications of three methods used to treat transverse patellar fractures, including titanium cable tension bands, compression screws with titanium cable cerclage, and X-shaped plating technique. METHODS: From January 2010 to March 2016, 120 cases of transverse patellar fracture received open reduction and internal fixation with one of three methods: titanium cable tension band (group A), compression screws with titanium cable cerclage (group B), and X-shaped plating technique (group C). Of these, 108 cases were followed for >2 years. Clinical and radiographic data were retrospectively collected and statistically compared. RESULTS: Final analysis included 108 patients (n = 38 in group A, 36 in B, and 34 in C). Reduction was satisfactory in all patients after surgery. No significant differences were noted in age, gender, time from injury to surgery, postoperative articular step-off, Lysholm score, and range of motion at 24 months among all groups. At final follow-up, 12 (31.6%) symptomatic implant complications were encountered in group A, along with 6 (16.7%) and 2 (5.9%) in groups B and C, respectively (p < 0.05). CONCLUSION: All three methods could achieve the goal of rigid fixation and early functional rehabilitation. However, the X-plate technique had the lowest risk of symptomatic implant complications and could thus be a safe and effective alternative for internal fixation of transverse patellar fractures.
BACKGROUND: Tension bands structures are widely used to treat transverse patellar fractures. However, many implants-related complications have been reported. The purpose of this study is to evaluate effects and compare complications of three methods used to treat transverse patellar fractures, including titanium cable tension bands, compression screws with titanium cable cerclage, and X-shaped plating technique. METHODS: From January 2010 to March 2016, 120 cases of transverse patellar fracture received open reduction and internal fixation with one of three methods: titanium cable tension band (group A), compression screws with titanium cable cerclage (group B), and X-shaped plating technique (group C). Of these, 108 cases were followed for >2 years. Clinical and radiographic data were retrospectively collected and statistically compared. RESULTS: Final analysis included 108 patients (n = 38 in group A, 36 in B, and 34 in C). Reduction was satisfactory in all patients after surgery. No significant differences were noted in age, gender, time from injury to surgery, postoperative articular step-off, Lysholm score, and range of motion at 24 months among all groups. At final follow-up, 12 (31.6%) symptomatic implant complications were encountered in group A, along with 6 (16.7%) and 2 (5.9%) in groups B and C, respectively (p < 0.05). CONCLUSION: All three methods could achieve the goal of rigid fixation and early functional rehabilitation. However, the X-plate technique had the lowest risk of symptomatic implant complications and could thus be a safe and effective alternative for internal fixation of transverse patellar fractures.