Comparison of a modified technique with conventional tension-band using Cable Grip System for comminuted patella fractures

Introduction: Treatment of comminuted patella fractures with tension band has resulted in impaired functional outcomes because the relationship between tension band and the tendons is always underestimated. We developed a modified enlacement (ME) technique to better place the tension-band under the quadriceps and patellar tendons and close to the patella. The study aimed to compare the ME with conventional enlacement (CE) technique regarding recovery of knee function. Patients and methods: 51 patients with comminuted patella fractures operated between January 2012 and December 2016 were reviewed retrospectively. 22 patients in the ME group (9 males and 13 females) with a mean age of 51.3 years, 29 patients in the CE group (16 males and 13 females) with a mean age of 47.1 years. ROM was measured at postoperative intervals of 1, 2, 4, 12, and 48 weeks; Knee function was evaluated using the Rasmussen scores at 4, 12, and 48 weeks postoperative. Results: There was no difference (P=0.082) regarding the fracture healing time between the two groups. Patients with the ME technique had clinically and statistically significantly higher ROM recovery throughout the study period (P < 0.001) with an earlier recovery. The Rasmussen scores also demonstrated significant improvements in patients with ME technique than CE group at all time-points (P < 0.05). Three patients in the CE group had migration of K-wires, with no migration observed in the ME group. Conclusion: The ME technique enables improved clinical outcomes and functional performance for the treatment of comminuted patella fractures. (C) 2019 Elsevier Ltd. All rights reserved.