From the Research
For transverse patellar fractures, the cannulated screw tension band (CSTB) technique is superior to other methods, including vertical and horizontal tension band wiring, in reducing postoperative complications and improving knee function, as demonstrated by a recent study 1. The choice between vertical and horizontal tension band wiring for transverse patellar fractures has been a topic of debate, with some studies suggesting that horizontal orientation may provide better functional results in the early stage after patella fractures 2. However, the most recent and highest quality study available 1 compared the CSTB technique with other methods, including K-wire with tension band (KTB) and ring pin tension band (RPTB) techniques, and found that CSTB was associated with a lower risk of postoperative complications and better knee function recovery. Key points to consider when treating transverse patellar fractures include:
- The use of CSTB technique, which has been shown to be superior to other methods in reducing postoperative complications and improving knee function 1
- The importance of proper implant placement and tensioning to ensure stable fixation and promote primary bone healing
- The need for postoperative rehabilitation, including the use of a hinged knee brace and progressive range of motion exercises, to optimize functional outcomes
- The potential benefits of using alternative fixation methods, such as X-shaped plating technique, which has been shown to have a lower risk of symptomatic implant complications 3 It is essential to note that the choice of fixation method should be individualized based on the specific fracture pattern, patient factors, and surgeon preference. However, based on the current evidence, the CSTB technique is the recommended method for treating transverse patellar fractures, due to its superior outcomes in terms of morbidity, mortality, and quality of life 1.