Background/Aim: Patella fractures significantly compromise the knee joint function and usually require surgical fixation to restore the knee ex-tensor mechanism. Tension band wiring (TBW) and locked patellar plate (LPP) are widely used surgical methods for the fixation of these fractures. Within 12-months post-surgery functional outcome using Lysholm knee score (LKS) as primary outcome and visual analogue score (VAS) were compared, degree of knew flexion, complication and radiographic union as a secondary outcome.Methods: Prospective comparative case series consecutively enrolled 24 patients with patella fractures allocated by chosen fixation method into: TBW (12/24) group and hooked part of the locked patellar plate (H/LPP) group (12/24). Patients' demographics, fractures criteria, 12-months LKS and 12-month VAS were recorded in addition to other secondary parame-ters (operative time, radiographic union, complication).Results:. At 1-year follow-up, mean LKS was significantly higher in H/LPP group vs TBW group (89.4 ± 4.8 vs 79.2 ± 6.5; p = 0.0016). The VAS scores were lower in H/LPP than TBW group (1.8 ± 0.9 vs 3.1 ± 1.2; p = 0.0042). Radiographic union time showed trend in H/LPP vs TBW group (10.3 ± 1.5 vs 11.2 ± 1.8 weeks; p = 0.125). Complications occurred in 4 (33.3 %) of TBW group (one wire breakage, 2 patients with k-wire promi-nence and superficial infection) while only one patient (8.3 %) had implant related discomfort as a complication which resolved spontaneously was seen in LPP group, p = 0.093.Conclusion: H/LPP fixation demonstrated superior functional outcomes, lower pain scores and fewer complications compared to TBW in the treat-ment of patella fractures, making it a recommendable option for patellar fracture management.
Jaffer et al. (Thu,) studied this question.