Management of comminuted inferior patellar pole fractures with cerclage-wire-augmented separate vertical wiring: a retrospective clinical study

Yan, Shuang G; Di, Li; Cui, Yiliang; Hua, Xingyi; Hemmann, Philipp; Schmidutz, Florian

doi:10.1007/s00402-021-04034-4

Cited by 9 publications

(15 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…None of the 16 identified studies performed a direct comparison between the KT and VW techniques. Eight studies 5,7,9,[15][16][17]27,28 involving 132 inferior pole fractures of the patella evaluated the results of the KT technique, while 8 studies 3,8,10,11,18,[29][30][31] involving 142 inferior fractures of the patella evaluated the results of the separate VW technique. All included studies had a minimum of 6 months of follow-up, and 9 5,8,11,15,17,18,[29][30][31] had a minimum of 1 year of follow-up (Table 1).…”

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

“…Eight studies 5,7,9,[15][16][17]27,28 involving 132 inferior pole fractures of the patella evaluated the results of the KT technique, while 8 studies 3,8,10,11,18,[29][30][31] involving 142 inferior fractures of the patella evaluated the results of the separate VW technique. All included studies had a minimum of 6 months of follow-up, and 9 5,8,11,15,17,18,[29][30][31] had a minimum of 1 year of follow-up (Table 1). Methodological quality assessment using MINORS showed pooled median MINORS of the KT and VW groups of 14.5 (range, 11-22) and 12 (range, [11][12][13][14][15][16][17], respectively (Table 1).…”

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Fixation Methods between Transosseous Pull-Out Suture and Separate Vertical Wiring for Inferior Pole Fracture of Patella: A Systematic Review and Meta-Analysis

Kim,

Son

2023

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

Objectives: To compare, in a systematic review, Krakow transosseous (KT) suturing and separate vertical wiring (VW) fixation methods in inferior pole fractures of the patella and to evaluate whether the supplementary fixation affected bone union. Data Sources: The MEDLINE, Embase, and Cochrane databases were searched from inception to January 15, 2023. The keywords were “patella inferior pole fracture”, “patella distal pole fracture”, “transosseous”, “pull-out suture”, “reattachment”, and “vertical wiring”. Study Selection: All clinical studies describing KT or VW techniques for inferior pole fracture of the patella and reporting bone union-related complications were included. Data Extraction: This meta-analysis included 16 studies with 274 patellae. Demographic data, surgical techniques, clinical outcomes, and complication rates were recorded. The Methodological Index for Non-Randomized Studies criteria were used to assess their quality. Data Synthesis: A meta-analysis was performed using random-effects models and meta-regression. The meta-analytic estimate of bone union-related complications was 3.8% (95% CI, 1.6%-6.0%) for either PO or VW techniques in inferior pole fractures of the patella. The bone union-related complication rates did not differ significantly between the two techniques (KT, 5.7%; VW, 3.0%; P=.277). Meanwhile, supplementation fixation was significantly associated with decrease in bone union-related complication rates (p=.013). Conclusion: Fixation of inferior pole fractures of the patella using either KT or VW techniques provided satisfactory and similar clinical results with minimal bone union-related complications. Supplementary fixation has a positive impact on reducing bone union-related complications in inferior pole fractures of the patella following KT and VW techniques.

show abstract

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

Section: Study Characteristics and Methodological Quality Assessmentmentioning

confidence: 99%

Comparison of Fixation Methods between Transosseous Pull-Out Suture and Separate Vertical Wiring for Inferior Pole Fracture of Patella: A Systematic Review and Meta-Analysis

Kim,

Son

2023

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

show abstract

“…Currently, this method is only used as the basis for combination fixation. 33,34 The WTB technique (Fig. 1E) is probably the most widely used technique for treating patellar fractures.…”

Section: Wiringmentioning

confidence: 99%

“…As a result, prolonged postoperative immobilization is required, often leading to complications, such as joint adhesions and stiffness. Currently, this method is only used as the basis for combination fixation 33,34 …”

Section: Introductionmentioning

confidence: 99%

Design and Validation of a Smile‐Necklace Plate for Treating Inferior Patellar Pole Avulsion Fractures: A Review and Hypothesis

Zhu

Xie

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

The patella's inferior pole transmits force generated by contraction of the quadriceps muscle to the tibial tuberosity through the attached patellar ligament, thus completing knee extension. Therefore, fractures of the patella's inferior pole disrupt the coherence of mechanical transmission in the lower extremities. There appears to be no consensus among trauma centers regarding the treatment of infrapatellar pole fractures, primarily because there is no consistent design or application of internal fixation for this type of fracture. We designed a new internal implant similar to the smile necklace based on our previous study. This smile‐necklace plate (SNP) has the advantage of both plate fixation and tension‐band wiring fixation, permitting early rehabilitation, especially in osteoporotic comminuted infrapatellar pole fractures. Finite element analysis helped verify the biomechanical advantages of the SNP in comparison with existing studies. Hence, this novel implant is a promising treatment option for inferior pole patellar fractures.

show abstract

“…1B) [4, 6, 9, 18, 23, 25, 27, 30–32], and the use of separated vertical wiring (SVW; Fig. 1C ) [5, 7, 10, 20, 33, 38, 42, 43, 45], tension band wiring (TBW; Fig. 1D ) [2, 3, 6, 8, 16, 22, 26, 35, 41, 44, 46, 48], suture anchors (SA; Fig.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of inferior pole fractures of the patella: a systematic review

et al. 2023

View full text Add to dashboard Cite

Purpose This study aimed to comprehensively review the existing evidence concerning surgical treatment of inferior pole fractures of the patella and to report the outcomes and complications of different fixation techniques. Method This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches of PubMed, Scopus, and Web of Science were conducted in March 2023. Studies were screened against predecided inclusion and exclusion criteria. The extracted data included fracture characteristics, surgical techniques, and radiographic and functional outcomes. The Methodological Index for Non-Randomized Studies (MINORS) quality assessment tool was used to assess the eligible literature. The primary outcome was postoperative range of motion of different surgical methods, and the secondary outcomes were other clinical results and complications. Results A total of 42 studies satisfied all the inclusion criteria and were deemed suitable for review. Fourteen case–control studies and 28 case series were selected, for a total of 1382 patients with a mean age of 51.0 years (range = 11–90). The follow-up period ranged from 6 to 300 months. The surgical techniques were categorized based on the device used as follows: (1) rigid fixation device; (2) tensile fixation device; (3) mixed device; and (4) extra-patella device. Conclusion Regarding the outcomes following surgical treatment of inferior pole fractures of the patella, the postoperative range of motion (ROM) of each technique ranged from 120° to 135°, with the exception of that involving the patellotibial wire which had poorer outcomes. The lowest functional score was also found in those using the patellotibial wire. Complications after surgery are rare, but approximately half of the patients required additional surgery for implant removal, particularly those whose initial surgery involved rigid fixation devices. It's worth noting that bony fragment excision is no longer recommended, and the combined use of multiple surgical devices is now more common.

show abstract

Management of comminuted inferior patellar pole fractures with cerclage-wire-augmented separate vertical wiring: a retrospective clinical study

Cited by 9 publications

References 16 publications

Comparison of Fixation Methods between Transosseous Pull-Out Suture and Separate Vertical Wiring for Inferior Pole Fracture of Patella: A Systematic Review and Meta-Analysis

Comparison of Fixation Methods between Transosseous Pull-Out Suture and Separate Vertical Wiring for Inferior Pole Fracture of Patella: A Systematic Review and Meta-Analysis

Design and Validation of a Smile‐Necklace Plate for Treating Inferior Patellar Pole Avulsion Fractures: A Review and Hypothesis

Surgical treatment of inferior pole fractures of the patella: a systematic review

Contact Info

Product

Resources

About