Patellar Fracture Fixation by Cerclage and Tension Band Wiring Technique versus Kirschner wires and Tension Band Wiring Technique

Abstract

Background: Fractures of patella constitute 1% of all fractures. Various techniques have been described for internal fixation of patella fractures. Superiority of one technique over the other has long been debated. Objective: We reviewed a series of seventy patients with transverse or comminuted fractures of patella treated with cerclage and tension band wiring technique to assess if it had any advantages over k. wires and tension band wiring technique. Type of the study: Retrospective study. Methods; Seventy patients with displaced patella fracture, with a mean age of 47 years (range 13-75) were divided into two groups :group A 36 patients were treated with cerclage and tension bands technique ,and group B 34 patients were fixed by 2 K. wires and tension bands technique. Clinical outcome was assessed using the system of Bostman score. Range of motion and evidence of radiological union were assessed at regular follow-ups. Results; All patients in group A gained Excellent result and good result, while only one patient gained poor result in group B . One patient (2.8%) developed superficial infection in group A and three patients( 8.8% ) developed superficial infection in group B. All fractures had united at the end of 10 weeks. Twenty two patients (31.4%) underwent a second surgery for wire removal; 5 cases in group A ( 13.9 % ) two of them due to implant related complications and 15 ( 44.1%) patients for group B mainly due to pain and interference with daily activity. Malunion or non-union was not noted in any of the cases. . Conclusion; The advantages of the cerclage and tension bands technique for fixation of displaced patella fracture are early mobilization, elimination of k-wire related complications, and ease of use in comminuted fracture pattern as well and a lower reoperation rates as compared to other method of fixation by 2 K. wires and tension bands technique. We strongly recommend its use in cases of displaced comminuted transverse fractures of patella .