title: Transosseous suturing of patellar fractures with braided polyester - a prospective cohort with a matched historical control study.
abstract: BACKGROUND
  Although tension-band wiring is the most widely used technique to fix patellar fractures, metal implant-related complications including implant failure and postoperative pain are very common and additional procedures are often necessary to treat the complications. The purpose of this study is to evaluate a totally metal-free technique using a transosseous suturing method and to compare it with the traditional fixation technique.
  
  
  METHODS
  A total of 25 patients (mean age of 59.60 years) with displaced patellar fractures treated by a transosseous suturing technique were compared with a 1:1 matched historical control group that underwent modified tension-band-wire fixation. Union time, union rate, operation time, number of procedures, mean hospitalisation days and complications were compared between cases and controls.
  
  
  RESULTS
  Union time (8.43 ± 2.92 vs. 8.64 ± 2.82 weeks) and operation time (69.00 ± 19.31 vs. 64.89 ± 14.27 min) were not different between the two groups. Mean hospitalisation days (4.04 ± 1.40 vs. 5.76 ± 1.50 days; P<0.001), number of procedures and the frequency of complications were significantly lower in the transosseous suturing group.
  
  
  CONCLUSIONS
  The transosseous suturing technique is safe and effective in the transverse or comminuted fractures of the patella. The complication rate is significantly lower than with the tension-band-wiring technique.
authors.affiliation: Department of Orthopedics, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
authors.forename: Chun-Ho
authors.initials: CH
authors.lastname: Chen
authors.forename: Hsing-Yao
authors.initials: HY
authors.lastname: Huang
authors.forename: Tuoh
authors.initials: T
authors.lastname: Wu
authors.forename: Jinn
authors.initials: J
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires / Q000009:adverse effects*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000601:surgery*; D011091:Polyesters / Q000627:therapeutic use; D011446:Prospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D014945:Wound Healing
chemical_list: D011091:Polyesters
keywords: Patellar fracture; Tension-band wiring; Transosseous suturing