Repurposing traditional cerclage and suture techniques for the reduction of comminuted patellar fractures

This study aimed to compare the cerclage and suture reduction technique with the point-type reduction technique in the management of comminuted patellar fractures using the modified Kirschner wire tension band.

We conducted a retrospective review of 84 patients with comminuted patellar fractures who were treated at our department between January 2021 and June 2024. All surgical procedures were performed by experienced senior orthopedic surgeons. According to the AO/OTA classification, forty-one patients were assigned to the the cerclage and suture reduction technique group (CS), four cases belong to type 34-C2 and 37 cases belong to type 34-C3 and 43 patients to the the point-type reduction technique group (PG), seven cases belong to type 34-C2 and 36 cases belong to type 34-C3. In both groups, definitive fixation was achieved using the standard Kirschner wire tension band technique with 2.0-mm K-wires and a 1.3-mm titanium cable. Routine follow-up radiographs of the knee were acquired to assess the quality of reduction and union of the fractures. Variables recorded included the number of patellar fracture fragments, operation time, Böstman score, knee joint range of motion and complications.

There were no significant differences between the two groups in terms of gender, age, fracture type, number of fracture fragments, or union time. The operation time was significantly shorter in the CS group than in the PG group (p < 0.001). The Böstman score was significantly higher in the CS group than in the PG group(p < 0.001). Additionally, there was a significant difference in range of motion between the two groups(p = 0.002). There was no statistically significant difference in complications between the two groups(P > 0.05), including limited flexion, anterior knee pain, K-wire migration, incision infection, loss of reduction, and poor reduction.

Compared with the point-type reduction technique, the cerclage and suture reduction technique achieves significantly shorter operative time and a simplified reduction process without increasing the complication rate.The cerclage and suture reduction technique, a simple, safe, and reproducible.