Non-metallic implants effective in fixing subcutaneous bone in patellar fractures, reveals research

A new study published in the recent issue of Frontiers of Surgery showed that the non-metallic implants are effective and can be used to treat patella fractures. In orthopedic surgery, patella fractures make up 1% of skeletal fractures. The majority of fractures are comminuted with considerable articular involvement and simple two-part patella fractures are rare. In the past, patella fractures were treated using a tension band approach by utilizing cerclage wire. The drawbacks of this method include soft-tissue irritation, implant migration, and breaking, which can result in up to 37% of patients needing to have a secondary implant removed.

More recent techniques for fixation like the cannulated screws, hook plates, mesh plates, and locking plates, appear promising but are expensive and need a thorough dissection of soft tissues. Suture tape and sutures have been added to patellar fixation procedures by a number of studies, with positive results. In order to treat common patella fracture types, such as AO 34C1.1 (transverse), AO 34C2 (transverse and split), and 34C3 (comminuted), this research by Wie Jie Tee and team suggested a unique all-suture tape approach. 

Technique:

• The patient is fully extended in a supine position.
• Anterior midline standard procedure is used.
• Cerclage wire is substituted with non-absorbable suture tapes after the fracture fragments have been reduced and secured with K-wires.
• The tapes are passed through the soft tissue several times, forming loops that are subsequently tensioned to compress the fracture pieces.
• Using extra suture tapes, a tension band fixation is created to finish the procedure.

Reduced operational time, less soft-tissue dissection, and a decreased chance of implant prominence and discomfort are just a few advantages of this approach that were expected. Due to the suture tape's exceptional tensile strength and little tissue reactivity, problems and the need for additional procedures are decreased. Early findings from two instances indicate union established at 3 months without problems, with patients recovering full range of motion.

Overall, this study provides evidence that non-metallic implants can be used to treat patella fractures. This technique yields encouraging outcomes that points to a possible change in fracture fixing techniques. More dedicated investigations and bigger cohort studies are required to confirm these results.

Source:

Tee, W. J., Yeo, K. S. A., Chua, D. T. C., & Moo, I. H. (2024). Novel technique for comminuted patellar fixation using suture tape in spiderweb configuration. In Frontiers in Surgery (Vol. 11). Frontiers Media SA. https://doi.org/10.3389/fsurg.2024.1377921