Comparison of Tension-Band Wiring With the Cable Pin System in Patella Fractures: A Randomized Prospective Study

J Orthop Trauma. 2015 Dec;29(12):e459-63. doi: 10.1097/BOT.0000000000000400.

Abstract

Objectives: To compare the outcome of tension-band wiring (TBW) with the cable pin system (CPS) for transverse fractures of the patella.

Design: Randomized prospective study.

Setting: Academic Level I trauma center.

Patients/participants: From February 2008 to December 2011, 73 consecutive patients with transverse fractures of the patella were prospectively enrolled in this study.

Intervention: The patients were randomly divided into 2 groups: one group was treated using the CPS, and the other group was treated using the modified TBW.

Main outcome measurements: The clinical outcome assessment included analyses of the radiographic images, the modified Hospital for Special Surgery scoring system, and complications.

Results: The follow-up time ranged from 12 to 29 months. All fractures healed, with a union rate of 100%. The fracture healing time was significantly shorter in the CPS group (8.51 ± 2.59 weeks, n = 34) compared with the TBW group (11.79 ± 3.04 weeks, n = 39). Postoperative complications in the CPS and TBW groups were observed in 1 and 9 patients, respectively, a difference that was statistically significant. The mean Hospital for Special Surgery score for the CPS group (90.53 ± 5.19 points) was significantly higher than that for the TBW group (81.36 ± 12.71 points).

Conclusions: The CPS is a viable option for transverse fractures of the patella and is associated with a shorter healing time, fewer complications, and better function than TBW.

Level of evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bone Nails*
  • Bone Wires*
  • Equipment Failure Analysis
  • Female
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Fixation, Internal / methods
  • Fracture Healing
  • Fractures, Bone / diagnosis*
  • Fractures, Bone / surgery*
  • Humans
  • Male
  • Middle Aged
  • Patella / injuries*
  • Patella / surgery
  • Prosthesis Design
  • Treatment Outcome