Study finds outcomes of tension band wiring & transosseous r
The aims of this study were:
(1) To compare clinical and radiological outcomes following fixation of inferior pole patellar fracture by using tension band wire (TBW) and transosseous reattachment (TOR) without excision of the bony fragment and
(2) To determine the risk factors for postoperative radiological loss of reduction.

Consecutive individuals with lower-pole patellar fracture have been enrolled for the retrospective cohort analysis. The patients were classified by their TBW or TOR technique and population data, clinical results and Insall–Salvati (IS) ratio postoperatively assessed. The patients are tested. The patients were then classified by radiologic reduction loss, probable loss risk variables identified, and odds ratios determined.

Results:
--This study included 55 patients with inferior pole patellar fracture; 30 patients were treated using TBW and 25 were treated using TOR.

--Clinical failure occurred in two patients in the TBW group (7%) and three in the TOR group (12%).

--The rate of radiological loss of reduction was significant higher in the TOR group, whereas removal of implants was significantly more common in the TBW group.

--Patella baja was noted immediately after surgery in the TOR group, but the IS ratios of the two groups were similar after 3 months.

--Fracture displacement of more than 30 mm was the only independent risk factor for postoperative radiological loss of reduction.

TWB and TOR were both successful and had a low rate of clinical failure in treating the lower polar patrol fracture. However, an extra surgery was needed to remove the implants in 60% of patients following TBW fixation. Patella baja happened right after TOR, but the patellar height after 3 months was identical to that of the TBW group. Surgeons should be cautious, particularly where the fracture displacement is more than 30 mm, of the increased potential of postoperative radiology loss of reduction.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02519-x
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