Patellar fracture fixation using cannulated screws and Fiber Wire tension band

Abstract

Purpose This study aims to evaluate the results of patellar fracture fixation using cannulated screws and FiberWire tension band. Patients and methods A prospective study was held in Benha University Hospital that included 30 patients with transverse patellar fractures fixed with cannulated screws with FiberWire tension band. All of the patients were followed up for a minimum period of 12 weeks, and the maximum period of follow-up was 24 weeks. Postoperatively, these patients were assessed clinically by the Levack’s score. Fracture union was confirmed radiologically. All patients were evaluated and assessed using the questionnaires at 3 and 6 months after surgery. Subjective evaluation consisted of recording pain using (visual analog scale), with categorization of pain into five levels: none, mild, moderate, severe, and unbearable. Results The mean age of the studied patients was 32 ± 9 years, and there was a male predominance (70%). More than half of the patients had right-sided affection (56.7%). The mechanisms of injury were direct (30%), falling (46.6%), or road traffic accidents (RTA) (23.3%). The affected side was the right side in 56.7% and the left side in 43.3%. The median time from injury was 3 days, and it ranged from 1 to 6 days. The mean time of surgery was 41 ± 18 min. All patients showed radiological union at 8 weeks, passive range of motion (ROM) at 4 weeks, active ROM at 6 weeks, start of weight-bearing as tolerated within brace at 4 weeks, and start of weight-bearing and ROM without restrictions at 8 weeks. At the final follow-up at 3 months, the median total Levack’s score was 12, and it ranged from 9 to 12. At 6 months, the median was 12, and the range significantly increased (11–12) (P<0.001). The reported complications were skin infection (13.3%), stiffness (6.7%), and mild pain (53.3%). Conclusion The use of cannulated screws with FiberWire tension band technique is a successful efficient treatment of transverse patellar fractures.