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Tension Band Fixation for Patellar Fractures Using K-Wires Versus Cannulated Screws: A Systematic Review and
Abdulrahman O Al-Naseem1, Yahya Ali2, Mohammed Alanzi3
1Division of Orthopaedic Surgery, McGill University, Montreal, Canada.
Cannulated screw tension band fixation (CSTB) offers better outcomes for patellar fractures than Kirschner wire fixation (KWTB), with less pain and fewer complications. Union rates are similar, but CSTB improves function and recovery time.
Area of Science:
- Orthopedic surgery
- Trauma care
- Biomedical engineering
Background:
- Tension band fixation (TBF) is standard for patellar fractures.
- Both Kirschner wire (KWTB) and cannulated screw (CSTB) methods are used.
Purpose of the Study:
- To compare postoperative outcomes of KWTB versus CSTB for patellar fractures.
- To determine the optimal fixation method for patellar fractures.
Main Methods:
- Systematic review and meta-analysis of 10 studies with 1,272 patients.
- Searched PubMed, MEDLINE, EMBASE, and CENTRAL.
- Compared primary outcomes: union rate, time to union, infection, reoperation, pain. Secondary outcomes: ROM, weight bearing, complications, function scores.
Main Results:
- KWTB showed longer union time, higher pain, and more infections than CSTB.
- Union and reoperation rates were comparable between KWTB and CSTB.
- CSTB resulted in better range of motion, faster weight-bearing, and fewer complications like implant issues and skin irritation.
Conclusions:
- CSTB is associated with improved functional outcomes and reduced complications compared to KWTB for patellar fractures.
- While union rates are similar, CSTB offers superior results in terms of patient recovery and implant-related issues.
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