The Outcomes of Cannulated Screws Versus Tension Band Wiring in Treatment of Transverse Patellar Fracture: A Comparative Study

Abstract

BACKGROUND: For the treatment of displaced patella fractures by tension bands with cannulated screws and by K-wire are widely employed. The clinical efficacy of the two therapy regimens, however, remains a point of contention. AIM: The study goal was to assess the relative advantages and drawbacks of open reduction and internal fixation using tension band wiring versus cannulated screws with wiring in patients sustained displaced patellar fracture. PATIENTS AND METHODS: A clinical trial study conducted in the Orthopedics Department at Al-Yarmook Teaching Hospital during a period of 18 months from June 2020 to November 2021. It included 22 adult patients diagnosed with isolated displaced transverse patellar fracture and scheduled for operative fixation. They were divided randomly into two groups: Tension band technique group (TBT) included 11 patients underwent open reduction internal fixation (ORIF) with TBT and cannulated screws (CS) group included 11 patients underwent ORIF by cannulated screws with wiring. A postoperatively follow-up was continued for 6 months. In which patients were assessed clinically and radiographically 4 time, at the end of the 1st, 2nd, 3rd, and 6th months. RESULTS: After 1, 2, and 3 months, means of Lysholm score and range of flexion were significantly higher; while mean of VAS score of pain was significantly lower in CS group than that in TBT group. No statistical significant differences in postoperative complications were found between study groups. CONCLUSION: Tension band wire with cannulated screws is the most effective surgical approach for internally repairing transverse fractures of the patella which allows for an early start to postoperative functional activity and an improved quality of life.