A combined tension-band braided polyester and suture button technique is a valuable treatment alternative for transverse patellar fractures in athletes

  • B. Bukva
  • P. D’HoogheEmail author
  • B. Poberaj
  • K. Alkhelaifi
  • M. Hutchinson
  • P. Landreau
Original Article



Transverse patellar fractures (TPFs) are uncommon in athletes, and their treatment can be challenging. Stable fixation is commonly achieved by compression screw fixation and stainless steel cerclage wire, but this technique can be associated with complications like nonunion, infection and the need for early hardware removal. We used a combined tension-band (figure-of-eight) braided polyester and suture button technique to treat four athletes who presented with transverse patellar fractures. This technique has shown to be a valuable alternative to the classic technique and allows for adequate fracture compression, stability and union in TPF.


Using a tension-band braided polyester and suture button technique (Arthrex FibreTapeR&TightRopeR), we treated four athletes with transverse patellar fractures from September 2015 till January 2017. The polyester was looped over the four suture button fixation points and tensioned in a figure-of-eight fashion. The average age of the athletes was 26 years (range 17–36). Follow-up ranged from 5 to 21 months. All four patients were treated using the same surgical technique (minimally invasive surgery) with the same postoperative recovery and the same physiotherapy protocol.


Full recovery using suture button adjustable loop fixation device was obtained in all four cases within 3 months after surgery, with fracture healing confirmed on postoperative radiographs. No patients required hardware removal. Potential problems with this technique can include bony tunnel malpositioning or soft tissue interpositioning underneath the suture buttons.


The combination of a suture button fixation and a braided polyester tension-band technique has shown to be a valuable alternative to the fracture management of transverse patella fractures in athletes. This results in fracture healing, low risk of complications and no need for hardware removal.


Patellar fractures Suture button Tension-band Athlete 


Compliance with ethical standards

Conflict of interest

All authors report no conflict of interest associated with the work presented in the submitted manuscript.


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Copyright information

© Istituto Ortopedico Rizzoli 2019

Authors and Affiliations

  1. 1.University Children’s HospitalBelgradeSerbia
  2. 2.Department of Orthopedic SurgeryAspetar Sports Medicine and Orthopedic Surgery HospitalDohaQatar
  3. 3.Sports Medicine and Human Performance CenterChicagoUSA

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