A novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical study
Abstract Background Tension band wiring (TBW) has conventionally been used for the open reduction and internal fixation of the patella. However, it suffers from distinct disadvantages such as large incision, implant irritation, and need for subsequent implant removal. Here, we propose a novel techni...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-04309-z |
| _version_ | 1797630116186030080 |
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| author | Feng Han Zhenjia Zhong Ming Zhou Qi Chen Yinan Liu Yongjun Rui Fengfeng Li |
| author_facet | Feng Han Zhenjia Zhong Ming Zhou Qi Chen Yinan Liu Yongjun Rui Fengfeng Li |
| author_sort | Feng Han |
| collection | DOAJ |
| description | Abstract Background Tension band wiring (TBW) has conventionally been used for the open reduction and internal fixation of the patella. However, it suffers from distinct disadvantages such as large incision, implant irritation, and need for subsequent implant removal. Here, we propose a novel technique using closed reduction and percutaneous fixation with three cannulated screws (TCS), which may be an alternative to this established conventional technique. Although some researchers have proposed alternative methods including closed reduction and cannulated screw fixation, with or without additional wires through the screws, and arthroscopic-assisted reduction and fixation, there are few studies that focus on the biomechanical stability of percutaneous fixation using only cannulated screws. Thus, the purpose of this study was to evaluate TCS versus TBW for simple transverse patellar fractures in cadaveric and patients' level, aiming to determine whether TCS show superiority over TBW in terms of biomechanical stability in a cadaveric study with benign clinical feasibility and outcomes in patients. Methods We conducted a cadaveric study with 15 knee specimens that had simple transverse patellar fractures. We used two fixation techniques: TBW (group A, n = 6) and TCS (group B, n = 9). We applied sinusoidal forces (25 N–125 N) at 1/5 Hz and 90° knee flexion to simulate knee movement. We compared the displacements at the fracture site between the two groups. We also used the same technique in a total of 23 patients and followed up them for at least 1 year. Results TCS demonstrated favourable biomechanical stability in the cadaveric study. The technique also performed excellently in terms of postoperative pain, knee function recovery, and complication rates during the follow-up period. Conclusions The technique provides a surgical treatment option with small incisions, minimal soft tissue irritation, and possibly lower removal rate of bothersome material. |
| first_indexed | 2024-03-11T11:02:21Z |
| format | Article |
| id | doaj.art-94643812f06844beae22570274616aa2 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-11T11:02:21Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-94643812f06844beae22570274616aa22023-11-12T12:24:26ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-11-0118111010.1186/s13018-023-04309-zA novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical studyFeng Han0Zhenjia Zhong1Ming Zhou2Qi Chen3Yinan Liu4Yongjun Rui5Fengfeng Li6Department of Hand Microsurgery, First Affiliated Hospital of Dalian Medical UniversityDepartment of Orthopedics, The Second Affiliated Hospital of Guangzhou Medical UniversityDepartment of Orthopedics, Wuxi 9th People’s Hospital Affiliated to Soochow UniversityFirst Affiliated Hospital of Dalian Medical UniversityGuangzhou Medical UniversityDepartment of Orthopedics, Wuxi 9th People’s Hospital Affiliated to Soochow UniversityDepartment of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityAbstract Background Tension band wiring (TBW) has conventionally been used for the open reduction and internal fixation of the patella. However, it suffers from distinct disadvantages such as large incision, implant irritation, and need for subsequent implant removal. Here, we propose a novel technique using closed reduction and percutaneous fixation with three cannulated screws (TCS), which may be an alternative to this established conventional technique. Although some researchers have proposed alternative methods including closed reduction and cannulated screw fixation, with or without additional wires through the screws, and arthroscopic-assisted reduction and fixation, there are few studies that focus on the biomechanical stability of percutaneous fixation using only cannulated screws. Thus, the purpose of this study was to evaluate TCS versus TBW for simple transverse patellar fractures in cadaveric and patients' level, aiming to determine whether TCS show superiority over TBW in terms of biomechanical stability in a cadaveric study with benign clinical feasibility and outcomes in patients. Methods We conducted a cadaveric study with 15 knee specimens that had simple transverse patellar fractures. We used two fixation techniques: TBW (group A, n = 6) and TCS (group B, n = 9). We applied sinusoidal forces (25 N–125 N) at 1/5 Hz and 90° knee flexion to simulate knee movement. We compared the displacements at the fracture site between the two groups. We also used the same technique in a total of 23 patients and followed up them for at least 1 year. Results TCS demonstrated favourable biomechanical stability in the cadaveric study. The technique also performed excellently in terms of postoperative pain, knee function recovery, and complication rates during the follow-up period. Conclusions The technique provides a surgical treatment option with small incisions, minimal soft tissue irritation, and possibly lower removal rate of bothersome material.https://doi.org/10.1186/s13018-023-04309-zTransverse patellar fractureCannulated screwMinimally invasiveClosed reduction and fracture fixation |
| spellingShingle | Feng Han Zhenjia Zhong Ming Zhou Qi Chen Yinan Liu Yongjun Rui Fengfeng Li A novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical study Journal of Orthopaedic Surgery and Research Transverse patellar fracture Cannulated screw Minimally invasive Closed reduction and fracture fixation |
| title | A novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical study |
| title_full | A novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical study |
| title_fullStr | A novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical study |
| title_full_unstemmed | A novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical study |
| title_short | A novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical study |
| title_sort | novel technique for treating simple transverse patellar fractures using cannulated screws a cadaveric and clinical study |
| topic | Transverse patellar fracture Cannulated screw Minimally invasive Closed reduction and fracture fixation |
| url | https://doi.org/10.1186/s13018-023-04309-z |
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