Evidence map›Paper›PMID 39251434›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024

Clinical and functional outcomes of locked plating vs. cerclage compression wiring for AO type C patellar fractures- a retrospective single-center cohort study.

Steven Bickel, Kai Oliver Jensen, Felix Karl-Ludwig Klingebiel, Michel Paul Johan Teuben, Roman Pfeifer, Hans-Christoph Pape, Christian Hierholzer, Yannik Kalbas

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. [Patellar fractures : Overview of surgical treatment concepts].Operative Orthopadie und Traumatologie · 2026
    Review
  2. Article
  3. Risk factors for reoperation following operative fixation of patella fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Article
  4. Review
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Steven BickelHarald-Tscherne Laboratory for Orthopaedic and Trauma Research, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland.ORCID http://orcid.org/0000-0002-6049-5290
Kai Oliver JensenDepartment of Trauma Surgery, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland.ORCID http://orcid.org/0000-0002-6207-8087
Felix Karl-Ludwig KlingebielDepartment of Trauma Surgery, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland.ORCID http://orcid.org/0000-0002-6438-5208
Michel Paul Johan TeubenDepartment of Trauma Surgery, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland.ORCID http://orcid.org/0000-0003-0310-4668
Roman PfeiferDepartment of Trauma Surgery, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland.ORCID http://orcid.org/0000-0003-1543-3995
Hans-Christoph PapeDepartment of Trauma Surgery, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland.ORCID http://orcid.org/0000-0002-2059-4980
Christian Hierholzer *Department of Trauma Surgery, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland.ORCID http://orcid.org/0009-0008-5009-2608
Yannik Kalbas *Department of Trauma Surgery, University Hospital Zurich, University of Zurich, Ramistr. 100, Zurich, 8091, Switzerland. yannik.kalbas@gmail.com.ORCID http://orcid.org/0000-0002-1550-328X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAlthough "tension-band wiring" is still commonly used to stabilize patellar fractures, the technique has recently been scrutinized due to biomechanical insufficiency. Consequently, the AO Foundation renamed the principle to compression cerclage wiring (CCW). Several studies propose favorable outcomes when utilizing locked plating (LP). This study aims to compare outcome of CCW and LP for complex patellar fractures.

methodsA retrospective, single-center cohort study was performed on patients who underwent operative treatment for (AO 34 C-Type) patellar fractures between April 2013 and March 2023. Patients with a 12 month follow up were included. We grouped and compared patients based on the applied treatment strategy: group LP vs. group CCW. Primary outcome parameters included implant-related complications and revision surgeries. Secondary outcomes were length of stay, return to work and 12 months functional outcome (Lysholm score). Odd ratios for complications and revisions were calculated using the conditional Maximum Likelihood Estimate. The threshold for statistical significance was set at p < 0.05.

resultsOf 145 patients, 63 could be included (group LP: n = 23 and group CCW: n = 40). Fractures in group LP were significantly more complex in regard to AO Classification (p < 0.001), number of fragments (p < 0.001) and degree of comminution (p < 0.001), yet odds of complications were significantly lower in group LP (OR: 0.147; 95%CI: 0.015-0.742; p = 0.009). K-wire migration was the most common complication in group CCW (20%). Odds of revision surgery were significantly lower in group LP (OR: 0.000; 95%CI: 0.000-1.120; p = 0.041). The average Lysholm score at one year was favorable in both groups (89.8; SD: 11.9 in group LP and 90.6; SD: 9.3 in group CCW; n.s.).

conclusionIn our study cohort, LP was routinely chosen for more complex fracture morphologies; nevertheless the data implies that LP may be considered as the superior fixation technique in regard to complications and revision operations. Especially, K-wire migration occurs frequently after CCW. The one year functional outcome was comparable between the groups, with both demonstrating good results. Prospective randomized studies are indicated to validate our findings.

Indexed as

Bone PlatesBone WiresFracture Fixation, InternalFractures, BonePatellaAdultAgedFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsReoperationRetrospective StudiesTreatment OutcomeAO 34 CComplicationsCompression cerclage wiringFunctional outcomesLocked platingPatellar fractureRe-operationsTension-band wiring

Identifiers

PMID39251434
PMCPMC11666649

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.