Clinical experience of patellar fracture fixation using metal wire or non-absorbable polyester--a study of 37 cases

The results of patellar fracture fixation using metal wire and non-absorbable polyester (5 Ethibond) are presented. In group 1 (21 cases), the standard "AO" technique using stainless steel wire was used, and in group 2 (16 cases) we used 5 Ethibond. Patients were assigned to the two groups on surgeon preference. Post-operative management in the two groups was similar, with patients being allowed to mobilise as comfort allowed, under the supervision of the physiotherapists. All patients were followed-up until union of the fractures or until further surgical intervention was carried out. At a mean of 2 years and 6 months (range 1-4 years), we reviewed the notes and X-rays of all 37 cases. In group 2 there were no cases of infection but there were three cases of post-operative infections in group 1. Re-operation rate was 6/21 (38%) in group 1 and 1/6 (6%) in group 2. Therefore, the relative risk of re-operation in the metal group is six times that in the non-absorbable polyester group. The risk of infection in the metal group is also higher. These have implication on patient morbidity associated with the operative treatment of patellar fractures. Non-absorbable polyester appears to compare favourably with the use of metallic wire to fix patellar fractures.