{"title":"Transosseous Suture With an All-FiberWire Technique in Patellar Fracture Fixation","authors":"Ponrachai Wongthongsalee, Thanapon Chobpenthai","doi":"10.1097/BTO.0000000000000579","DOIUrl":null,"url":null,"abstract":"Background: Patellar fractures account for 0.5% to 1.5% of all bone fractures. Tension band wiring with heavy gauge steel wire and K-wires is traditionally procedure for treating patellar fractures. However, this method is associated with implant-related complications. Present study aimed to evaluate functional clinical outcomes of patellar fracture fixation with transosseous suture using an all-FiberWire technique. Methods: This was a retrospective study involving 16 patellar fractures patients were repaired by open reduction and internal fixation with FiberWire using a 3-transosseous tunnel technique. The functional outcomes were evaluated with Tegner-Lysholm and Bostman scoring. We also evaluated clinical and radiologic outcomes. Results: The mean time to bony union was 8.87±1.54 weeks (range, 7 to 12 wk). The mean Bostman score at final follow-up was 27.13±2.5 (range, 21 to 30), and mean Lysholm score at final follow-up was 90.69±5.75 (range, 83 to 100). Fractures healed in all patients, with no fixation failures. Minor loss of reduction (<2 mm) were observed in 3 patients (18.75%). No patient has reoperation. One patient developed knee stiffness, with an infected hematoma 10 weeks postoperatively. None of patients developed anterior knee pain postoperatively. Two patients (12.5%) developed mild localized pain from prominent suture knots. There were no significant implant-related complications and no repeat surgery was necessary. Conclusions: The use of nonmetallic sutures with an all-FiberWire technique in patellar fracture fixation avoids implant-associated complications and possibility of a second surgery to remove metal implants. Nonmetallic high-resistance FiberWire matches traditional metallic fixation, with a reduced risk of postoperative complications. Level of Evidence: Level IV (therapeutic).","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"13 1","pages":"224 - 231"},"PeriodicalIF":0.2000,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/BTO.0000000000000579","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 1
Abstract
Background: Patellar fractures account for 0.5% to 1.5% of all bone fractures. Tension band wiring with heavy gauge steel wire and K-wires is traditionally procedure for treating patellar fractures. However, this method is associated with implant-related complications. Present study aimed to evaluate functional clinical outcomes of patellar fracture fixation with transosseous suture using an all-FiberWire technique. Methods: This was a retrospective study involving 16 patellar fractures patients were repaired by open reduction and internal fixation with FiberWire using a 3-transosseous tunnel technique. The functional outcomes were evaluated with Tegner-Lysholm and Bostman scoring. We also evaluated clinical and radiologic outcomes. Results: The mean time to bony union was 8.87±1.54 weeks (range, 7 to 12 wk). The mean Bostman score at final follow-up was 27.13±2.5 (range, 21 to 30), and mean Lysholm score at final follow-up was 90.69±5.75 (range, 83 to 100). Fractures healed in all patients, with no fixation failures. Minor loss of reduction (<2 mm) were observed in 3 patients (18.75%). No patient has reoperation. One patient developed knee stiffness, with an infected hematoma 10 weeks postoperatively. None of patients developed anterior knee pain postoperatively. Two patients (12.5%) developed mild localized pain from prominent suture knots. There were no significant implant-related complications and no repeat surgery was necessary. Conclusions: The use of nonmetallic sutures with an all-FiberWire technique in patellar fracture fixation avoids implant-associated complications and possibility of a second surgery to remove metal implants. Nonmetallic high-resistance FiberWire matches traditional metallic fixation, with a reduced risk of postoperative complications. Level of Evidence: Level IV (therapeutic).
期刊介绍:
The purpose of Techniques in Orthopaedics is to provide information on the latest orthopaedic procedure as they are devised and used by top orthopaedic surgeons. The approach is technique-oriented, covering operations, manipulations, and instruments being developed and applied in such as arthroscopy, arthroplasty, and trauma. Each issue is guest-edited by an expert in the field and devoted to a single topic.