Optimizing Treatment Strategies for Comminuted Low Pole Patella Fractures: a Comparative Analysis of Anchor Suture With Double Pulley vs Tension Band Wiring vs Hybrid Techniques

Background : This study evaluates the clinical effects of three different surgical methods used in treating comminuted fractures of low pole patella fractures in adults. Results : Surgical time in Group A is longer than that of Group B, while the median surgical time in Group C is the longest among the three groups. Bleeding time in Group A is longer than that of Group B, while the median bleeding volume of Group C is the longest among the three groups. Range of Motion among the groups, Group A had a higher range of motion but just slightly higher than C and B had the least. However, two and three patients in Groups C and B experienced k-wire loosening, wire dislocation and soft tissue irritation caused by k-wires. Conclusion : TBW, although associated with shorter surgical time and less blood loss has limited efficacy in restoring joint function. Anchor suture with double pulley technique showed the best outcomes among the three groups, despite increased surgical time and blood loss. Compared to TBW and hybrid techniques, anchor suture with double pulley technique proved better ROM and lower complication rates. Therefore, for comminuted low pole patella fractures, anchor suture with double pulley technique may be the optimal choice for satisfactory results.