ArticleBMC musculoskeletal disorders2025
Comparing all-suture repair versus tension band wiring fixation in patellar fractures.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionImplant-related issues necessitating removal are well reported in tension band wiring (TBW) of patellar fractures. Suture materials can minimize complications associated with TBW fixation but there is a paucity of literature on all-suture fixation outcomes. This study aims to compare outcomes between all-suture versus TBW fixation of patellar fractures.
methodsThis retrospective, single-centre study included 79 patients with patellar fractures that underwent fixation with either all-suture (n = 49) or TBW (n = 30) fixation from 2020 to 2023, regardless of demographic or fracture characteristics. Outcomes reported include intra-operative duration, length of stay, bony union rate and time, post-operative knee range of motion, complications, and re-operation rate.
resultsMean age in years was 63.5 ± 11.9 and 65.2 ± 12.9 in the all-suture and TBW groups respectively. Bony union time in months was comparable between the all-suture group (4 ± 1.58) and TBW group (4.37 ± 1.81) (p = 0.34). Union rate was comparable between all-suture (98%) and TBW groups (100%). Complication rate was lower in the all-suture group (4.1%) when compared to the TBW group (13.3%) (p = 0.19). 10% of TBW group patients underwent re-surgery due to implant-related complications compared to 0 cases of re-surgery in the all-suture group (p = 0.05). More patients in the TBW group (23.3%) experienced flexion contracture as compared to the all-suture group (2%) (p = 0.004), and with a greater degree of contracture of 2.1° ± 4.6 vs. 0.2 ± 1.4 (p = 0.002). The all-suture group had a higher prevalence of post-operative patellar baja (67.3%) (p = 0.002). However, this was found to have no significant impact on the presence of knee contracture after subgroup analysis (p = 1.00). No significant differences were seen in operative duration, length of stay and post-operative knee flexion between the two groups (p > 0.05).
conclusionAll-suture fixation of patellar fractures is a reliable surgical method with a high union rate, good union time and post-operative range of motion, while avoiding implant-related complications that may result in re-operation. It is a safe alternative surgical technique in fixation of patellar fractures.
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