Cannulated Screws and Braided Polyester Tension Band as an Alternative for Fixation of Transverse Patella Fracture: A Finite Element Analysis Study

Abstract

T he patella plays an important biomechanical role in knee function. Patella injuries constitute up to 1-2% of all fractures, with 70-90% of these having a transverse fracture pattern. 1-5 Patella fractures may result in discontinuity of extensor mechanism and potential patellofemoral (PF) joint incongruity. 6 As a consequence, effective treatment strategy of patella fractures is essential. For displaced transverse fracture of the patella, the most commonly used technique is modified tension-band wiring. 3, 7-14 The Arbeitsgemeinschaft für Osteosynthesefragen (AO) recommends 15 a modified tension band wiring involving two parallel Kirschner wires and a stainless-steel figure-of-eight wire loop. Nonetheless, various complications have been associated with metal implants in this configuration in 18-50% of patients. 12, 16-26 Symptomatic hardware is the most commonly reported complication following fixation of a patellar fracture. 12, 16, 17, 25 Lazaro et al., 26 reported 11of 30 (37%) patients with patellar fracture requiring removal of symptomatic implants. Wire breakage and K-wire migration were also reported by several authors. 20-24 Other common complications include fixation failure, infection, delayed or non-union, and arthrofibrosis. 12, 19, 20