Transosseous suturing of patellar fractures with braided polyester - a prospective cohort with a matched historical control study

Abstract

Background: Although tension-band wiring is the most widely used technique to fix patellar fractures, metal implant-related complications including implant failure and postoperative pain are very common and additional procedures are often necessary to treat the complications. The purpose of this study is to evaluate a totally metal-free technique using a transosseous suturing method and to compare it with the traditional fixation technique.

Method: A total of 25 patients (mean age of 59.60 years) with displaced patellar fractures treated by a transosseous suturing technique were compared with a 1:1 matched historical control group that underwent modified tension-band-wire fixation. Union time, union rate, operation time, number of procedures, mean hospitalisation days and complications were compared between cases and controls.

Results: Union time (8.43 ± 2.92 vs. 8.64 ± 2.82 weeks) and operation time (69.00 ± 19.31 vs. 64.89 ± 14.27 min) were not different between the two groups. Mean hospitalisation days (4.04 ± 1.40 vs. 5.76 ± 1.50 days; P<0.001), number of procedures and the frequency of complications were significantly lower in the transosseous suturing group.

Conclusion: The transosseous suturing technique is safe and effective in the transverse or comminuted fractures of the patella. The complication rate is significantly lower than with the tension-band-wiring technique.

Keywords: Patellar fracture; Tension-band wiring; Transosseous suturing.