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3D reduction combined with the modified Kirschner-wire tension band for the treatment of comminuted patella fracture

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

A novel 3D reduction method combined with a modified Kirschner-wire tension band (3D MKTB) fixation method to treat comminuted patella fractures was introduced in this study. This study aims to evaluate the effectiveness and practicality of this novel technology.

Methods

This study is a retrospective case series study. Twenty-eight patients with closed comminuted patella fractures were treated with the novel 3D MKTB fixation method. Radiographs of the knee were obtained at the routine follow-up to assess fracture healing and widening of the articular step-off. Clinical outcomes including the degree of pain on a visual analogue scale (VAS), range of motion, Lysholm, and Bostman grading scales were measured at the last follow-up. The mean follow-up was 39.8 ± 10.5 (range 26–62) months.

Results

All patients had bony union at a mean of 11.4 ± 1.4 (range 9–14 weeks) weeks based on X-ray. No patient had evidence of internal fixation failure. Only two patients suffered from surgical complication. One patient suffered from postoperative superficial infection, and one patient suffered from internal fixation irritation. Articular step-off larger than 2 mm was not seen in any cases. The average VAS-related pain score was 0.5 ± 0.5 (range 0–1) points. The average range of motion was 0–138.6° ± 11.9° (range 90°–155°), all patients had full knee extension. The mean Lysholm and Bostman scores were 92.9 ± 3.5 (range 86–100 points) points and 28.5 ± 1.3 (range 24–30 points) points, respectively.

Conclusion

The novel 3D reduction technique combined with the modified Kirschner-wire tension band technique is an effective, safe, and simple treatment option for comminuted patella fractures.

Level of evidence

IV.

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Acknowledgements

G.F. and Y.M. contributed equally to this work and should be considered as equal first authors.

Funding

This research was funded by West China Hospital of Sichuan University (2019HXFH041), Natural Science Foundations of China (no. 81501879 and no. 31870961), Foundation of SinoGerman centre for research promotion (GZ1219), the International Cooperation Project of the Science and Technology Department of Sichuan Province (Grant no. 2015HH0049, no. 2017SZ0127) and the National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University (Z2018A11).

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Author notes

  1. Feng Gao and Min Yi contributed equally to this work and should be considered as equal first authors.

Authors and Affiliations

  1. Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, #37 Guoxue Road, Chengdu, 610041, Sichuan, People’s Republic of China

    Feng Gao, Min Yi, JiaXin Liu, Xiang Zhang, Zhou Xiang & Xin Duan

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  1. Feng Gao
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Correspondence to Xin Duan.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of West China Hospital, Sichuan University (Chengdu, China; Approval No. 2019-1040).

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Informed consent was obtained from the study participants prior to study commencement.

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Gao, F., Yi, M., Liu, J. et al. 3D reduction combined with the modified Kirschner-wire tension band for the treatment of comminuted patella fracture. Arch Orthop Trauma Surg 143, 1957–1963 (2023). https://doi.org/10.1007/s00402-022-04400-w

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