Effectiveness of three-needle and two-cable structure in treatment of inferior patellar pole avulsion fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DUAN Cheng ¹ ,  CHENG Jie ²

1. Graduate School of Inner Mongolia Medical University, Hohhot Inner Mongolia Autonomous Region, 010030, P. R. China;
2. Department of Trauma Area C, the Second Affiliated Hospital of Inner Mongolia Medical, Hohhot Inner Mongolia Autonomous Region, 010030, P. R. China;

Corresponding author：

CHENG Jie, Email: 48212903@qq.com

Keywords：

Inferior patellar pole avulsion fracture; internal fixation; three-needle and two-cable structure; tension band technique

DOI：

10.7507/1002-1892.202504011

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of three-needle and two-cable structure in the treatment of inferior patellar pole avulsion fractures. Methods A clinical data of 62 patients with inferior patellar pole avulsion fractures who were admitted between January 2023 and December 2023 and met the selection criteria was retrospectively analyzed. Among them, the fractures were fixed with three-needle and two-cable structure in 32 patients (observation group) and traditional steel wire tension band in 30 cases (control group). There was no significant difference in the baseline data of age, gender, side of the affected limb, cause of injury, and disease duration between the two groups (P>0.05). The operation time, fracture healing and healing time, patellar height (Insall-Salvati index), occurrence of complications, knee range of motion, and Böstman score at last follow-up were compared between the two groups. Results The operation time of the observation group was significantly shorter than that of the control group (P<0.05). Patients in both groups were followed up 6-12 months (mean, 10.4 months). X-ray re-examination showed that all fractures healed, and the fracture healing time was significantly shorter in observation group than in control group (P<0.05). During follow-up, the complications occurred in 2 cases (6.25%) in observation group and 9 cases (30.00%) in control group, and the difference in the incidences was significant (P<0.05). At last follow-up, the range of motion and Böstman score of the knee joint in observation group were superior to control group (P<0.05). Conclusion Compared with the traditional steel wire tension band fixation, the three-needle and two-cable structure is used to treat the inferior patellar pole avulsion fractures with firm fixation, which allows the knee joint to move early after operation and is conducive to the recovery of knee joint function.

1.	Tsivelekas K, Pallis D, Lykos S, et al. Patella fracture after total knee arthroplasty: a review. Cureus, 2024, 16(1): e53281. doi: 10.7759/cureus.53281.
2.	Rajeev A, Krishnan S, Koshy G, et al. Stress avulsion fracture of the patellar tendon following open reduction and internal fixation of a transverse patella fracture with cannulated screws. Cureus, 2024, 16(8): e66590. doi: 10.7759/cureus.66590.
3.	汤俊峰, 孙良业, 凤晓翔, 等. 髌骨下极粉碎性骨折两种内固定的比较. 中国矫形外科杂志, 2024, 32(14): 1279-1284.
4.	Zhu W, Xu L, Xie K, et al. Design and validation of a smile-necklace plate for treating inferior patellar pole avulsion fractures: a review and hypothesis. Orthop Surg, 2022, 14(11): 2799-2808.
5.	向锋, 张锡平, 陈侠甫, 等. 矩形钢丝环扎联合8字钢丝张力带与传统克氏针钢丝张力带对治疗髌骨横形骨折的早中期疗效比较. 中华损伤与修复杂志 (电子版), 2024, 19(3): 251-254.
6.	何宏庆, 李宁凯, 刘猛, 等. 带线锚钉三维立体捆扎治疗髌骨下极撕脱性骨折. 中国修复重建外科杂志, 2025, 39(1): 26-31.
7.	Rajeev A, Krishnan S, Koshy G, et al. Stress avulsion fracture of the patellar tendon following open reduction and internal fixation of a transverse patella fracture with cannulated screws. Cureus, 2024, 16(8): e66590. doi: 10.7759/cureus.66590.
8.	Yang KH, Cho H, Kim D, Park YC. Articular fragment detachment and separate fixation for the treatment of comminuted patellar fractures with coronal split articular fragments: articular detachment technique. Clin Orthop Surg, 2024, 16(3): 357-362.
9.	Kim KS, Suh DW, Park SE, et al. Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique. Arch Orthop Trauma Surg, 2021, 141(11): 1889-1897.
10.	Oh HK, Choo SK, Kim JW, et al. Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing. Injury, 2015, 46(12): 2512-2515.
11.	Chang CH, Shih CA, Kuan FC, et al. Surgical treatment of inferior pole fractures of the patella: a systematic review. J Exp Orthop, 2023, 10(1): 58. doi: 10.1186/s40634-023-00622-y.
12.	Henrichsen JL, Wilhem SK, Siljander MP, et al. Treatment of patella fractures. Orthopedics, 2018, 41(6): e747-e755.
13.	Alley MC, Kain M, Mitchell S, et al. Anterior hook plating of patella fractures: a biomechanical analysis and clinical series. J Orthop Trauma, 2023, 37(6): e258-e263.
14.	Steinmetz S, Brügger A, Chauveau J, et al. Practical guidelines for the treatment of patellar fractures in adults. Swiss Med Wkly, 2020, 150: w20165. doi: 10.4414/smw.2020.20165.
15.	Jang JH, Cho YJ, Choi YY, et al. Hammock plating for comminuted inferior sleeve avulsion fractures of the patella: A surgical technique and clinical results. Orthop Traumatol Surg Res, 2021, 107(3): 102866. doi: 10.1016/j.otsr.2021.102866.
16.	Fan W, Liu J, Tan X, et al. Candy box technique for the fixation of inferior pole patellar fractures: finite element analysis and biomechanical experiments. BMC Musculoskelet Disord, 2023, 24(1): 835. doi: 10.1186/s12891-023-06946-1.
17.	Cho JW, Kent WT, Cho WT, et al. Miniplate augmented tension-band wiring for comminuted patella fractures. J Orthop Trauma, 2019, 33(4): e143-e150.
18.	Zhu W, Xie K, Li X, et al. Combination of a miniplate with tension band wiring for inferior patellar pole avulsion fractures. Injury, 2020, 51(3): 764-768. doi: 10.1016/j.injury.2020.01.028. Epub 2020 Jan 23.
19.	谢美明, 廖冬发, 龚凯, 等. 多向三维钢丝环套固定治疗髌骨下极撕脱骨折疗效分析. 中国修复重建外科杂志, 2021, 35(2): 183-187.
20.	高跃川, 王歆峰, 赵良春, 等. 改良锚钉置入角度和应用双滑轮技术治疗髌骨下极撕脱骨折. 中国骨伤, 2022, 35(7): 683-687.

1. Tsivelekas K, Pallis D, Lykos S, et al. Patella fracture after total knee arthroplasty: a review. Cureus, 2024, 16(1): e53281. doi: 10.7759/cureus.53281.
2. Rajeev A, Krishnan S, Koshy G, et al. Stress avulsion fracture of the patellar tendon following open reduction and internal fixation of a transverse patella fracture with cannulated screws. Cureus, 2024, 16(8): e66590. doi: 10.7759/cureus.66590.
3. 汤俊峰, 孙良业, 凤晓翔, 等. 髌骨下极粉碎性骨折两种内固定的比较. 中国矫形外科杂志, 2024, 32(14): 1279-1284.
4. Zhu W, Xu L, Xie K, et al. Design and validation of a smile-necklace plate for treating inferior patellar pole avulsion fractures: a review and hypothesis. Orthop Surg, 2022, 14(11): 2799-2808.
5. 向锋, 张锡平, 陈侠甫, 等. 矩形钢丝环扎联合8字钢丝张力带与传统克氏针钢丝张力带对治疗髌骨横形骨折的早中期疗效比较. 中华损伤与修复杂志 (电子版), 2024, 19(3): 251-254.
6. 何宏庆, 李宁凯, 刘猛, 等. 带线锚钉三维立体捆扎治疗髌骨下极撕脱性骨折. 中国修复重建外科杂志, 2025, 39(1): 26-31.
7. Rajeev A, Krishnan S, Koshy G, et al. Stress avulsion fracture of the patellar tendon following open reduction and internal fixation of a transverse patella fracture with cannulated screws. Cureus, 2024, 16(8): e66590. doi: 10.7759/cureus.66590.
8. Yang KH, Cho H, Kim D, Park YC. Articular fragment detachment and separate fixation for the treatment of comminuted patellar fractures with coronal split articular fragments: articular detachment technique. Clin Orthop Surg, 2024, 16(3): 357-362.
9. Kim KS, Suh DW, Park SE, et al. Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique. Arch Orthop Trauma Surg, 2021, 141(11): 1889-1897.
10. Oh HK, Choo SK, Kim JW, et al. Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing. Injury, 2015, 46(12): 2512-2515.
11. Chang CH, Shih CA, Kuan FC, et al. Surgical treatment of inferior pole fractures of the patella: a systematic review. J Exp Orthop, 2023, 10(1): 58. doi: 10.1186/s40634-023-00622-y.
12. Henrichsen JL, Wilhem SK, Siljander MP, et al. Treatment of patella fractures. Orthopedics, 2018, 41(6): e747-e755.
13. Alley MC, Kain M, Mitchell S, et al. Anterior hook plating of patella fractures: a biomechanical analysis and clinical series. J Orthop Trauma, 2023, 37(6): e258-e263.
14. Steinmetz S, Brügger A, Chauveau J, et al. Practical guidelines for the treatment of patellar fractures in adults. Swiss Med Wkly, 2020, 150: w20165. doi: 10.4414/smw.2020.20165.
15. Jang JH, Cho YJ, Choi YY, et al. Hammock plating for comminuted inferior sleeve avulsion fractures of the patella: A surgical technique and clinical results. Orthop Traumatol Surg Res, 2021, 107(3): 102866. doi: 10.1016/j.otsr.2021.102866.
16. Fan W, Liu J, Tan X, et al. Candy box technique for the fixation of inferior pole patellar fractures: finite element analysis and biomechanical experiments. BMC Musculoskelet Disord, 2023, 24(1): 835. doi: 10.1186/s12891-023-06946-1.
17. Cho JW, Kent WT, Cho WT, et al. Miniplate augmented tension-band wiring for comminuted patella fractures. J Orthop Trauma, 2019, 33(4): e143-e150.
18. Zhu W, Xie K, Li X, et al. Combination of a miniplate with tension band wiring for inferior patellar pole avulsion fractures. Injury, 2020, 51(3): 764-768. doi: 10.1016/j.injury.2020.01.028. Epub 2020 Jan 23.
19. 谢美明, 廖冬发, 龚凯, 等. 多向三维钢丝环套固定治疗髌骨下极撕脱骨折疗效分析. 中国修复重建外科杂志, 2021, 35(2): 183-187.
20. 高跃川, 王歆峰, 赵良春, 等. 改良锚钉置入角度和应用双滑轮技术治疗髌骨下极撕脱骨折. 中国骨伤, 2022, 35(7): 683-687.

Chinese Journal of Reparative and Reconstructive Surgery

Latest ArticlesEffectiveness of three-needle and two-cable structure in treatment of inferior patellar pole avulsion fractures

Abstract Full text Figures/Tables Video References Cited by

Format

Content