Treatment of patella fracture with circumferential wiring plus cannulated lag screws tension band

Objective To investigate the clinical effects of patella fractures treated with circumferential wiring plus cannulated lag screws tension band.Methods From January 2006 to May 2008,41 cases of patella fractures were treated with circumferential wiring plus cannulated lag screws tension band.25 females and 16 males,ages ranged from 45 to 86 years old(average 58.8).According to Regazzoni patella fracture classification,there were 11 type B1,21 type B2,and 9 type B3 fractures.Direct force 12 cases,indirect force 29 cases.After open reduction,fractures were first fixed with circumferential wires(diameter 0.8 mm),and then two parallel K-wires were inserted from proximal bottom or distal pole across the fracture line,followed by two 4.0 mm cannulated lag screws respectively.Then 0.6 mm wire was passed through two screws canal to create a figure-eight pattern tension band on the anterior surface of patella.Results 38 cases were followed-up for a mean of 8 months.3 cases were lost.All fractures were healed without complications such as incision infection,loosening of fixation.16 cases had light soft tissue irritation.No patient was removed the fixation due to implants.The mean healing time was 6.5 weeks.32 cases were good,6 were fair according to Bstman’s knee joint functional scale of patella fracture 2 weeks after fracture healing.Conclusion Circumferential wiring plus cannulated screw tension band is a reliable fixation for patella fracture.