Morphological Characteristics of Inferior Pole Patellar Fractures and a Finite Element Analysis Combined with a Retrospective Clinical Study of Anchor Suture and Titanium Cable Cerclage Treatment

Soochow University

Status: Completed

Conditions: Finite Element Analysis; Inferior Patellar Fracture; Fracture Maps

Treatments: Procedure: Anchor Suture with Titanium Cable Cerclage; Procedure: Kirschner wire tension band + cerclage cable

Study type: Observational

Funder types: Other

Identifiers

NCT06736639

JD-HG-2024-064

Details and patient eligibility

About

The goal of this study is to compare the biomechanical stability and clinical outcomes of two treatment methods for inferior pole patellar fractures (IPPF): anchor suture with patellar cerclage and Kirschner-wire tension band combined with patellar cerclage. The study involves patients with IPPF, focusing on fracture patterns and treatment outcomes.

1. Undergo retrospective analysis of fracture patterns using fracture mapping.
2. Participate in biomechanical analysis via finite element modeling of both treatment methods.
3. Be part of a clinical comparison between two surgical treatments based on operative time, postoperative complications, and functional outcomes.

Enrollment: 57 patients

Sex: All

Ages: 35 to 70 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

(1) diagnosis of IPPF confirmed by X-ray or CT, and (2) patients aged between 18 and 70 years.

Exclusion criteria

(1) concomitant fractures of other parts of the knee, (2) open fractures, and (3) pathological fractures.

Trial design

57 participants in 2 patient groups

Anchor + titanium cable cerclage (ISB-LP)

Description:

This group includes patients with inferior pole patellar fractures (IPPF) treated using anchor suture fixation combined with titanium cable cerclage. The intervention involves securing fracture fragments with anchors to provide stable fixation, reinforced by a titanium cable cerclage for additional stability. This method is intended to reduce hardware-related complications while maintaining biomechanical stability and supporting functional recovery. The outcomes for this group include operative time, postoperative knee range of motion, incidence of complications, need for secondary surgery, and functional scores such as the Bostman score.

Treatment:

Procedure: Anchor Suture with Titanium Cable Cerclage

TBW-LP fixed (TBW-LP group)

Description:

This group includes patients with inferior pole patellar fractures (IPPF) treated using Kirschner-wire tension band combined with patellar cerclage (TBW-LP group). This intervention involves the placement of Kirschner wires to create a tension band construct across the fracture site, stabilizing the fragments, with additional support provided by a cerclage wire. This method is widely used in clinical practice due to its simplicity and cost-effectiveness. The study evaluates key outcomes for this group, including operative time, knee range of motion, incidence of postoperative complications such as hardware irritation or infection, and functional recovery based on Bostman scores. This group serves as a comparison to newer techniques like anchor suture with titanium cable cerclage.

Treatment:

Procedure: Kirschner wire tension band + cerclage cable