The Clinical Outcomes and Complications of Combined Fixation with Cannulated Screws and the Modified Pyrford Technique for the Treatment of Transverse Patellar Fractures: a Case Series Study

Overview

Journal BMC Surg

Publisher Biomed Central

Specialty General Surgery

Date 2022 Sep 10

PMID 36088315

Authors

Yihan Li

Qingxian Tian

Kunpeng Leng

Meng Guo

Affiliations

Soon will be listed here.

Abstract

Background: Transverse patellar fractures can be fixed using various techniques. The purpose of the current study was to assess the clinical outcomes and complication rate of a combined fixation technique using cannulated screws and the modified Pyrford technique with nonabsorbable polyester sutures.

Methods And Patients: Between January 2015 and February 2021, 26 transverse patellar fractures were fixed with this combined technique. Preoperative data were collected from patients with transverse patellar fractures who were followed up for at least 12 months. At each follow-up visit, plain radiographs were taken. At the 12-month postoperative follow-up, range of motion of the affected knee joint and clinical outcomes, as evaluated by the Bostman scoring system, were recorded.

Results: The average Bostman score at the 12-month postoperative follow-up was 28.3 ± 1.5. Furthermore, the average extension and flexion of the knee joint were 1.2 ± 2.1 and 125.6 ± 6.7 degrees, respectively. One patient experienced delayed bone union and one experienced superficial wound infection. There were no other postoperative complications. One patient required removal of the device for social-psychological reasons.

Conclusions: The combined fixation technique with cannulated screws and the modified Pyrford technique with suture materials produced excellent clinical outcomes and a low rate of complications in the treatment of transverse patellar fractures.

Citing Articles

Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study.

Xiang F, Xiao Y, Li D, Ma W, Chen Y, Yang Y Front Bioeng Biotechnol. 2024; 12:1340482.

PMID: 38515618 PMC: 10955129. DOI: 10.3389/fbioe.2024.1340482.

References

Westberg S, Acklin Y, Hoxha S, Ayranci C, Adeeb S, Bouliane M . Is suture comparable to wire for cerclage fixation? A biomechanical analysis. Shoulder Elbow. 2019; 11(3):225-232. PMC: 6555108. DOI: 10.1177/1758573217735323. View

Adjal J, Ban I . Patella fractures treated with suture tension band fixation. J Orthop Surg Res. 2021; 16(1):179. PMC: 7942173. DOI: 10.1186/s13018-021-02309-5. View

Burvant J, Thomas K, Alexander R, Harris M . Evaluation of methods of internal fixation of transverse patella fractures: a biomechanical study. J Orthop Trauma. 1994; 8(2):147-53. DOI: 10.1097/00005131-199404000-00012. View

Patel V, Parks B, Wang Y, Ebert F, Jinnah R . Fixation of patella fractures with braided polyester suture: a biomechanical study. Injury. 2000; 31(1):1-6. DOI: 10.1016/s0020-1383(99)00190-4. View

Tan H, Dai P, Yuan Y . Clinical results of treatment using a modified K-wire tension band versus a cannulated screw tension band in transverse patella fractures: A strobe-compliant retrospective observational study. Medicine (Baltimore). 2016; 95(40):e4992. PMC: 5059058. DOI: 10.1097/MD.0000000000004992. View

Zhang D, Kong C, Zhang M, Kang J . Religious Belief-Related Factors Enhance the Impact of Soundscapes in Han Chinese Buddhist Temples on Mental Health. Front Psychol. 2022; 12:774689. PMC: 8825353. DOI: 10.3389/fpsyg.2021.774689. View

Buezo O, Cusco X, Seijas R, Sallent A, Ares O, Alvarez-Diaz P . Patellar Fractures: An Innovative Surgical Technique With Transosseous Suture to Avoid Implant Removal. Surg Innov. 2015; 22(5):474-8. DOI: 10.1177/1553350615591913. View

Lee K, Lee Y, Lee Y, Cho B, Kim M, Baek G . Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins. J Orthop Surg (Hong Kong). 2019; 27(3):2309499019882140. DOI: 10.1177/2309499019882140. View

Lee H, Kim B, Ryu H, Dan J . Vertical Interfragmentary Doubled Suture for Displaced Patella Fractures: Sequential Compressive Tightening with Nice Knot. Clin Orthop Surg. 2020; 12(3):413-416. PMC: 7449849. DOI: 10.4055/cios20018. View

10.

Camarda L, La Gattuta A, Butera M, Siragusa F, DArienzo M . FiberWire tension band for patellar fractures. J Orthop Traumatol. 2015; 17(1):75-80. PMC: 4805633. DOI: 10.1007/s10195-015-0359-6. View

11.

Carpenter J, Kasman R, Patel N, Lee M, Goldstein S . Biomechanical evaluation of current patella fracture fixation techniques. J Orthop Trauma. 1997; 11(5):351-6. DOI: 10.1097/00005131-199707000-00009. View

12.

Egol K, Howard D, Monroy A, Crespo A, Tejwani N, Davidovitch R . Patella fracture fixation with suture and wire: you reap what you sew. Iowa Orthop J. 2014; 34:63-7. PMC: 4127725. View

13.

Curtis M . Internal fixation for fractures of the patella. A comparison of two methods. J Bone Joint Surg Br. 1990; 72(2):280-2. DOI: 10.1302/0301-620X.72B2.2312569. View

14.

Hoshino C, Tran W, Tiberi J, Black M, Li B, Gold S . Complications following tension-band fixation of patellar fractures with cannulated screws compared with Kirschner wires. J Bone Joint Surg Am. 2013; 95(7):653-9. DOI: 10.2106/JBJS.K.01549. View

15.

Chen A, Hou C, Bao J, Guo S . Comparison of biodegradable and metallic tension-band fixation for patella fractures. 38 patients followed for 2 years. Acta Orthop Scand. 1998; 69(1):39-42. DOI: 10.3109/17453679809002354. View

16.

Gwinner C, Mardian S, Schwabe P, Schaser K, Krapohl B, Jung T . Current concepts review: Fractures of the patella. GMS Interdiscip Plast Reconstr Surg DGPW. 2016; 5:Doc01. PMC: 4717300. DOI: 10.3205/iprs000080. View

17.

Kumar A, Narang A, Chouhan D, Passey J . Letter to editor concerning "Patella fractures treated with cannulated lag screws and FiberWire® have a high union rate and low rate of implant removal " by Busel, Gennadiy et al. injury, 2019 (in press). Injury. 2019; 51(2):574. DOI: 10.1016/j.injury.2019.11.019. View

18.

Greenwald D, Shumway S, Albear P, Gottlieb L . Mechanical comparison of 10 suture materials before and after in vivo incubation. J Surg Res. 1994; 56(4):372-7. DOI: 10.1006/jsre.1994.1058. View

19.

Bostrom A . Fracture of the patella. A study of 422 patellar fractures. Acta Orthop Scand Suppl. 1972; 143:1-80. DOI: 10.3109/ort.1972.43.suppl-143.01. View

20.

Gerber C, Schneeberger A, Beck M, Schlegel U . Mechanical strength of repairs of the rotator cuff. J Bone Joint Surg Br. 1994; 76(3):371-80. View