A New Antirotation Strategy of K-Wire Tension Band Therapy for Patellar Fracture

Fengpo Sun; Yawen Zhang; Quan Ji; Tongyi Zhang; Yi Zhu; Ze Zhang; Ruining Han; Liangyuan Wen

doi:10.3389/fsurg.2022.891869

A New Antirotation Strategy of K-Wire Tension Band Therapy for Patellar Fracture

Front Surg. 2022 May 10:9:891869. doi: 10.3389/fsurg.2022.891869. eCollection 2022.

Authors

Fengpo Sun¹, Yawen Zhang¹, Quan Ji¹, Tongyi Zhang¹, Yi Zhu¹, Ze Zhang¹, Ruining Han¹, Liangyuan Wen¹

Affiliation

¹ Department of Orthopedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Abstract

Background: Patellar fracture is a common phenomenon observed in orthopedic clinics. Many methods have been shown to be effective in the fixation of patellar fracture. However, there are few studies on the antirotation effect of these methods. The purpose of this study is to present a new strategy of K-wire tension band therapy for patellar fracture and explore the antirotation effect of the modified tension band method on patellar fracture.

Methods: A retrospective clinical observation study was conducted on 75 patients with patellar fracture. Totally, 46 patients were enrolled to the traditional group, who received the traditional K-wire tension band therapy. The modified group included 29 patients on whom our new strategy was implemented. The operation time, intraoperative blood loss, and fracture healing time were collected to compare the two operations and the knee society score (KSS) scores after the operations, and complications were recorded and retrieved to indicate the effectiveness of the two treatments.

Results: The preoperative baseline data (gender, age, fracture types) of the two groups showed no significant statistical difference. Similarly, there was no significant difference in the operation time, intraoperative blood loss, and fracture healing time between the two groups. The KSS clinical scores 1 year after operation was 90 (84, 95) for the traditional group as compared with 99 (97, 100) for the modified group (p < 0.05). The KSS functional scores 1 year after operation in the two groups were 90 (65, 90) and 100 (90, 100) (p < 0.05). The incidences of complications due to the rotation of K-wires in the traditional group and the modified group were 76.1% (35 of 46) and 6.9% (2 of 29) with a significant statistical difference (p < 0.05).

Conclusion: This study shows that our modified tension band therapy is an effective strategy for antirotation in the treatment of patellar fracture and proves that it can achieve better clinical outcomes than the traditional K-wire tension band method. This new strategy may be a safe and effective clinical technique for the treatment of patellar fracture. However, more prospective randomized controlled trials with larger sample sizes are still needed to further prove its efficacy.

Keywords: antirotation; internal fixation; patellar fracture; tension band method; trauma.