Effect analysis of transosseous wire fixation for patella fractures: therapeutic efficacy.
Huilong Zeng, Hualin Zeng, Zhangsheng Dai, Kaibin Fang, Xiaocong Lin
Abstract
Open AccessBACKGROUND: Open reduction and internal fixation (ORIF) represents a standard surgical technique for the management of patellar fractures, with tension band fixation serving as the commonly employed method. To enhance fixation strength, wires are frequently threaded through the medullary canal of the bone. This study aims to evaluate the potential benefits of utilizing transosseous wire fixation in the treatment of patellar fractures and its impact on patient outcomes. METHOD: In this study, 223 patients with patellar fractures who had undergone open reduction and tension band surgery at our hospital were included, and a retrospective case-control study was conducted. The patients were divided into two groups: fixation using pin-tail bolt locking intramedullary Kirschner wires was received by one (observation group), while the standard treatment protocol was received by the other (control group). Both groups were followed regularly for one year, and postoperative complications were recorded. A comparative analysis was performed to evaluate differences in postoperative functional recovery and knee joint range of motion between the two groups. All statistical analyses were carried out using SPSS (version 26.0). RESULTS: A total of 223 patients were included in the study; 72 of these were assigned to the observation group and received transosseous wire placement, while the remaining patients were assigned to the control group. No significant differences were observed between the two groups in terms of gender, age, or fracture type. No statistically significant difference was found in the number of intraoperative X-ray fluoroscopies (P = 0.11). However, the operative time was significantly longer in the observation group compared with the control group (P < 0.05). No significant differences were detected in the incidence of nonunion (P = 0.56), refracture (P = 0.58), internal fixator fracture (P = 0.32), or wound infection (P = 0.96) between the two groups. In contrast, a statistically significant difference was observed in the incidence of internal fixation loosening (P < 0.05). Among patients with internal fixation loosening, no significant difference was noted in Bostman scores between the control and observation groups (P = 0.60). CONCLUSION: It is indicated by findings that although postoperative complication rates are not increased by the use of transosseous wire fixation in patellar fractures, no significant benefits are provided by this technique in terms of functional scores, knee range of motion, or the rate of fracture healing.