A Comparison of the Efficacy of Cannulated Screws against Modified Tension Band Wire in the Management of Slightly Displaced Fractures of the Patella: A Novel Technique

Abstract

Aim: The study aimed to compare the outcomes of Open Reduction and Cannulated Screw Fixation (ORCF) and Open Reduction and Tension Band Wire Fixation (ORTF)   for treating minimally displaced patellar fractures, with the intention to discern the  more efficacious surgical method in terms of various clinical and radiographic  parameters. 

Methods: The research was a retrospective controlled trial  encompassing 63 patients, culminating in a final data set of 52 patients with transverse patellar fractures with less than 8 mm of displacement. Patients were assessed postoperatively at three, six, and twelve months using measures such as  the Lysholm score, Visual Analog Scale (VAS) for pain, and goniometry for active  knee extensions and flexion. Statistical analyses were performed using SPSS version  22.0. 

Results: Results indicated superior clinical outcomes for the ORCF group at  twelve months post-treatment, with notable higher Lysholm scores and lower VAS  scores for pain at three-, six-, and twelve-month intervals. The ORCF group also  demonstrated improved flexion and range of motion, with an average fracture  healing time of 2.65 months and significantly lower complication rates, compared to  the ORTF group. 

Conclusions: The ORCF method, leveraging headless compression  screws and cerclage wire fixation, emerges as a promising approach for managing  minimally displaced transverse patellar fractures, potentially offering improved  clinical results and patient satisfaction in comparison to the traditional ORTF  method. Further expansive and diverse studies are warranted to substantiate these  findings.