Closed reduction high-strength sutures have good clinical efficacy in treating transverse patella fractures

Tension band wiring (TBW) is probably the most commonly used and effective surgical method. Still, inevitably, it has the disadvantages of protruding discomfort, soft tissue irritation, and the need for secondary surgical removal.

Liben Huanget et al used a closed repositioning method combined with high-strength sutures to overcome the problem of protruding implants without affecting stable fixation. They conducted a study to investigate the clinical efficacy of closed reduction high-strength sutures combined with Nice knots in treating transverse patella fractures.

The authors retrospectively analyzed the clinical data of 28 patients who underwent surgery for transverse patella fractures. Twelve cases of the study group were treated with closed reduction high-strength sutures combined with Nice knots, and 16 cases in the control group were treated with tension band wiring. The study has been published in ‘Indian Journal of Orthopaedics.’

Two or three 1.5 or 2.0 mm clincher pins were placed percutaneously in the parallel longitudinal direction as temporary fixation after reduction of transverse fracture patella. Next, two lateral and two medial incisions were made on each side of the patella at the superior and inferior patellar poles, respectively. Next, through four small incisions, the Ultrabraid NO.2 (Smith & Nephew, USA) was looped and "8" fixed, superiorly through the quadriceps; inferiorly through the inferior pole of the patella. Finally, the Nice knot was tied in the patellar epiphysis and embedded in soft tissue. Next, the kyphosis pin was pulled out in sequence, and the knot was then tied longitudinally through the bone tunnel through the skin and tightened using Nice. After bone fixation was completed, intraoperative fixation stability was assessed by flexing the knee to 90 degrees. . The incision was finally sutured and bandaged.