Patella fractures account for 0.5% to 1.5% incidence of all bone fractures. The gold standard procedure for the patella fractures so far is AO modified anterior tension band wiring with stainless steel and K-wires. The hardware related complication in this technique is high ranging from 0-60%. The purpose of the study is to evaluate the functional outcome for fixation done with high resistance suture material.
Methods: A prospective study was conducted in a group of 24 patients who were hospitalised in Govt Kilpauk Medical College and Hospital, Chennai in the Department of Orthopaedics between August 2015 and September 2017. The patella fractures included in the study were performed open reduction and internal fixation (ORIF) with FiberTape using a novel transosseous tunnel technique. The functional outcomes were evaluated with Tegner-Lysholm score and Bostman scoring. The clinical and radiological outcomes were evaluated as well.
Results: Among the 24 patients with patella fractures studied, all fractures united. The mean time of union is 3 months 8 days. 4 patients presented with minor complications like superficial infection, displacement < 4mm, anterior knee pain and extensor lag ~ 10°. Average scores: Lysholm – 96, Bostman – 27. All fractures united uneventfully. No hardware related complications or resurgery reported in the study.
Conclusion: The complete non-metallic fixation rules out the most important complication of metallic fixation, which is the symptomatic hardware. It also brought down the reoperation rates and the infection rates post-surgery considerably. Using a non-absorbable suture material also precludes the possibility of a second surgery needed for the implant exit. Hence, these high resistance suture materials like Fiber Wire and FiberTape can be used for efficient non-metallic fixation of patella on par with that of traditional metallic fixation with reduced complications and re-surgery rates.