Novel technique for comminuted patellar fixation using suture tape in spiderweb configuration

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Surgical Innovation

Background:

• Patella fractures are uncommon, with traditional cerclage wire fixation leading to high complication rates.
• Existing newer methods are costly and require extensive dissection, highlighting a need for improved techniques, especially for elderly patients with osteoporotic bone.

Purpose of the Study:

• To introduce and describe a novel all-suture tape method for patella fracture fixation.
• To evaluate the feasibility and preliminary outcomes of this suture tape technique for various patella fracture types.

Main Methods:

• A supine positioning with the knee in full extension and a standard anterior midline approach.
• Fracture fragments are reduced and temporarily fixed with K-wires, followed by fixation using non-absorbable suture tapes instead of cerclage wire.
• Suture tapes are passed through soft tissue, tensioned to compress fragments, and secured with a tension band construct.

Main Results:

• The all-suture tape technique is suitable for common patella fracture types (AO 34C1.1, 34C2, 34C3).
• Benefits include reduced operative time, minimized soft-tissue dissection, and lower risk of implant-related complications.
• Early results from two cases demonstrated union at 3 months with full range of motion and no complications.

Conclusions:

• The all-suture tape method is a feasible and promising alternative for patella fracture fixation.
• This non-metallic implant technique offers advantages over traditional and newer fixation methods.
• Further research with larger studies is warranted to validate these preliminary findings.