Tension Band Fixation for Patellar Fractures Using Cannulated Screws had less complication rate compared with K wires: study

Dr Supreeth  D R

Tension Band Fixation for Patellar Fractures Using Cannulated Screws had less complication rate compared with K wires: study

Written By : Dr Supreeth D R Published On 2026-09-29T07:00:30+05:30 | Updated On 29 Sept 2026 12:13 PM IST

Tension band fixation (TBF) using screws or wires is the widely accepted standard of care for patellar fractures. Abdulrahman O. Al-Naseem et al conducted a meta-analysis, aimed to quantitatively compare postoperative outcomes between Kirschner wire tension band fixation (KWTB) and cannulated screw tension band fixation (CSTB) to determine the optimal fixation method. The article has been published in ‘JBJS Open access.’

A systematic review and meta-analysis were conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for comparative studies on KWTB vs. CSTB. Primary outcomes included union rate, time to union, infection, reoperation rate and pain. Secondary outcomes included range of motion, time to weight bearing, implant complications, and functional scores.

The key findings of the study were:

• This meta-analysis included 10 studies.

• These studies collectively evaluated 1,272 patients (786 in KWTB, 504 in CSTB).

• The mean age of participants ranged from 35.96 ± 10.75 to 63.65 ± 12.91 years. BMI values ranged from 22.07 ± 1.49 to 26.17 ± 4.92 kg/m 2.

• KWTB was associated with a significantly longer time to union (p = 0.02), greater pain scores (p < 0.0001), and higher infection rates (p = 0.04). However, union and reoperation rates were comparable.

• For secondary outcomes, CSTB had significantly improved time to full weight bearing (p < 0.00001). In addition, KWTB had higher complication rates, including implant migration/loosening (p < 0.00001), implant prominence, skin irritation (p = 0.003), and implant removal (p < 0.00001).

• The Lysholm score (p < 0.00001) and range of motion (p = 0.03) were significantly higher in the CSTB group.

The authors concluded – “CSTB fixation is associated with better functional outcomes, faster recovery, and lower complication rates compared with KWTB fixation. Large multicenter trials would aid in the development of standardized clinical protocols to optimize treatment strategies.”

Level of Evidence: Level III

For further details on the article refer to:

Tension Band Fixation for Patellar Fractures Using K-Wires Versus Cannulated Screws A Systematic Review and Meta-Analysis Abdulrahman O. Al-Naseem et al JBJS Open Access 2026:e25.00162. http://dx.doi.org/10.2106/JBJS.OA.25.00162

Tension Band FixationPatellar FracturesK-WiresCannulated ScrewsJBJS Open Access

Source : JBJS Open Access

Dr Supreeth D R

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

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