ArticleFrontiers in surgery2025
Comparative clinical outcomes of dual cannulated screw-cable system vs. Kirschner wire-cable fixation in type C patellar fractures.
Article in Frontiers in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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7 authors.
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Abstract
Introduction: To compare the clinical efficacy and safety of the dual cannulated screw-cable (DCSC) system with those of conventional Kirschner wire-cable (KWC) fixation in the management of patellar fractures. Traditional KWC fixation, while widely used since the 1970s, is associated with high complication rates, including symptomatic hardware irritation (up to 42%) and loss of reduction (12%-15% in transverse fractures), due to its biomechanical limitations such as lack of interfragmentary compression and prominent hardware causing soft tissue irritation. The DCSC system, introduced as a promising alternative, offers active interfragmentary compression and reduced soft tissue irritation, potentially addressing these limitations. However, few clinical studies have directly compared the outcomes of DCSC and KWC fixation in patellar fractures. This study aims to fill this gap by evaluating functional recovery, radiographic union, and complication rates between the two fixation methods. Methods: This retrospective cohort study included 127 patients with patellar fractures (AO/OTA 34-C) treated between January 2020 and December 2023. The patients were stratified into DCSC ( Results: The DCSC group demonstrated superior short-term functional outcomes, with significantly higher Lysholm scores at 3 months (76.0 ± 6.1 vs. 70.4 ± 2.9, Conclusion: Compared with KWC fixation, the DCSC system provides superior early functional recovery, fewer complications, and faster fracture healing, particularly in complex intra-articular fractures (OTA 34-C2). However, the benefits of the DCSC system in simpler or more comminuted fracture (C1/C3) diminish over time, and caution is warranted when using this system in comminuted or distal coronal plane fractures owing to potential compression limitations. These findings support the use of DCSC as a first-line option for C2 fractures, although long-term studies are needed to assess implant durability.
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