Management of Patella Fractures Non-amenable to Tension Band Wiring: Series of Nine Cases with Review of Literature

INTRODUCTION: Patella fractures account for about 1% of all musculoskeletal injuries. Modified tension band wiring (TBW) is the most commonly used technique for the management of patella fractures. However, all patella fractures are not-amenable to TBW. In this series, we present nine cases managed with open reduction and internal fixation using non-absorbable braided polyester suture (Ethicon Ethibond Excel 5-0) with circumferential stainless-steel wiring. CASE SERIES: This series included nine patients with fractured patella and managed with open reduction and internal fixation with non-absorbable sutures and circumferential wiring. Patient demographics, fracture type, time to union, functional outcome, and complications were recorded. Patients were followed up for minimum of 6 months (11.6 ± 3.7 months). All fractures went on to unite with average fracture healing time of 13.8 weeks. Mean Lyshom and Bostman score were 83 and 25.6, respectively. Seven patients had excellent to good outcome. One each had fair and poor outcomes. One patient developed superficial infection and knee stiffness. CONCLUSION: Open reduction and fixation with non-absorbable sutures augmented with circumferential wiring are an efficient method for the management of severely comminuted and multi-fragmentary lower pole patella fractures with minimum complications.