Revisiting Tension Band Principle Using Fiber Tape in Patella Fractures in Terms of Functional Outcomes, Complications, and Resurgery

Introduction: Post-operative complications related to hardware, particularly symptoms caused by it, such as implant impingement, wire breakage, and skin infection are frequently reported following surgical management of patellar fractures with stainless steel wires. As a potential solution, some researchers have advocated for the use of non-absorbable sutures for fracture fixation. This study aims to investigate the clinical and radiological outcomes of patients treated with fiber taping as an alternative technique.

Materials and methods: We conducted a retrospective evaluation of 20 patients diagnosed radiographically with displaced patellar fractures (including transverse, poles, and severely comminuted). These patients underwent tension band technique with the help of high strength polyethylene fiber tape. Clinical and radiological outcomes were meticulously assessed, with specific attention to union time, complications, and functional outcome assessed by the Lysoholm scoring system, all of which were carefully observed and documented.

Results: The mean age of the patients was 42.5 ± 14.3 years, and the majority were male (70%). The mean operative time was 68.5 ± 22.4 min. All fractures achieved union without any reported cases of wound complications, infections, loss of reduction, or implant failure. The mean Lysholm Knee Score improved from 36.4 ± 8.2 at baseline to 92.1 ± 5.9 at 12-month post-surgery. The visual analogue scale for pain decreased from 7.8 ± 1.4 at baseline to 0.8 ± 0.6 at 12 months. The mean range of motion improved from 96.5° ± 12.8° of flexion and -5.2° ± 3.1° of extension at baseline to 134.2° ± 6.1° of flexion and 0.6° ± 0.7° of extension at 12 months.

Conclusion: Our investigation into a modified tension band technique using fiber tape sutures revealed encouraging clinical outcomes, marked by minimal complications. The adoption of fiber tape as a substitute for metal wire counterparts in patellar fracture treatment shows potential for reducing hardware related symptoms and shows lesser morbidity.