A Prospective Study of Comminuted Patellar Fractures Treated with Different Fixation Modalities: Functional Outcomes...

Area of Science:

• Orthopedic surgery
• Trauma management
• Biomechanical fixation

Background:

• Comminuted patellar fractures are common and challenging, with limited outcome data from India.
• Effective surgical management is crucial for restoring knee function.

Purpose of the Study:

• To compare functional outcomes of four surgical techniques for comminuted patellar fractures.
• Evaluate tension band wiring (TBW), modified TBW (MTBW), cannulated screw TBW, and modified cerclage wiring (MCW).

Main Methods:

• Prospective observational study of 46 surgically managed comminuted patellar fractures.
• Outcomes assessed using Böstman score at 1, 3, 6, and 12 weeks.
• Fisher's exact test for intergroup comparison (P < 0.05).

Main Results:

• All techniques provided satisfactory outcomes at 12 weeks.
• Modified tension band wiring (MTBW) showed the highest rate of excellent results (56.3%).
• Complications occurred in 15.2%, most in the TBW group; no significant differences between methods (P=0.443).

Conclusions:

• All four fixation methods are suitable for comminuted patellar fractures.
• Individualized fixation choice based on fracture pattern and surgeon expertise is recommended.
• MTBW and MCW show promising results for excellent outcomes and lower complication rates, respectively.