A Novel Technique for Supplementing Transosseous Suture Repair of Inferior Pole Patella Fractures with a Tension Band.

INTRODUCTION: The transosseous suture fixation is a recognised surgical technique for inferior pole patella fractures. However, post-operative range of motion (ROM) is typically restricted to reduce complications of fracture displacement. We present a novel modified surgical technique using a supplemental Ethibond figure-of-eight stitch to reinforce the transosseous suture repair and studied its outcomes. We performed a retrospective study looking at outcomes of patients with displaced inferior pole patella fractures who underwent modified suture fixation from 2010 to 2018. OPERATIVE TECHNIQUE: In the modified suture fixation technique, after the standard transosseous repair was performed, the remnant Ethibond suture was placed in a figure-of-eight tension band fashion anteriorly across the patella. Immediate post-operative ROM was allowed if the fixation was stable. The patients were assessed up to 6 months post-surgery to monitor for fracture displacement/gap and for bony union. CASE SERIES: We analysed the results of 14 patients who underwent modified suture repair. All patients were allowed immediate post-operative ROM. Only 1 fixation failure (7%) was noted at 6 months.
CONCLUSION: Complication rates were low with the modified technique even when patients were allowed immediate post-operative mobilisation. This shows greater confidence in the stability of the fixation and represents a viable technique for early mobilisation post-fixation of inferior pole patella fractures. © Indian Orthopaedics Association 2020.