Comparison of the treatment of patellar inferior pole fractures with combined vertical wire and mini steel plate fixation versus independent vertical wire fixation.

Abstract

Patellar fractures, in particular inferior pole fractures, pose significant challenges due to the patella's complex biomechanics and crucial role in knee extension and stability. This study aimed to compare the therapeutic effectiveness and long-term efficacy of two fixation methods: combined vertical wire and mini steel plate fixation versus independent vertical wire fixation. The comparison was based on clinical classification, addressing the ongoing debate regarding optimal management strategies for patellar inferior pole fractures. A retrospective cohort study was conducted, analyzing 226 patients with patellar inferior pole fractures. Patients were divided into two groups: the independent vertical wire fixation group (n = 117) and the combined vertical wire and mini steel plate fixation group (n = 109). Demographic data, clinical characteristics, surgical outcomes, functional outcomes, pain levels, return to daily activities, quality of life, and both short-term and long-term complications were assessed and compared between the two groups. The combined fixation group demonstrated significantly superior surgical outcomes, including shorter operation times and lower infection rates, despite higher blood loss. Furthermore, this group exhibited enhanced functional outcomes, reduced pain levels, and lower rates of osteoarthritis and salvage procedures compared with the independent fixation group. The findings of this study suggest potential advantages of combined vertical wire and mini steel plate fixation over independent vertical wire fixation in the treatment of patellar inferior pole fractures. The combined fixation method was associated with improved surgical outcomes, enhanced functional recovery, better pain management, and reduced long-term complication rates.