Kirschner wire-assisted PDS nice knot fixation for C3-type patellar fractures: a retrospective comparative study with low-profile locking plates

Objective This study aims to evaluate the clinical efficacy of Kirschner wire (K-wire)-assisted PDS Nice knot fixation compared with low-profile locking plate fixation for treating AO/OTA C3-type patellar fractures. Methods A total of 53 patients with C3-type patellar fractures treated between January 2021 and January 2024 were retrospectively analyzed. Patients were divided into two groups based on the surgical method: 29 underwent K-wire-assisted PDS Nice knot fixation (experimental group), and 24 received low-profile locking plate fixation (control group). Perioperative data, radiological findings, and postoperative functional outcomes were compared between the two groups. Results There were non-significant differences between groups in incision length, intraoperative blood loss, fracture healing time, or hospital stay ( P  > 0.05). However, the experimental group demonstrated significantly shorter operative time, fewer X-ray exposures, lower visual analog scale pain scores on postoperative day 5, and better articular surface congruity ( P  < 0.05). One month postoperatively, the experimental group exhibited superior knee range of motion and Bostman scores ( P  < 0.01). However, a non-significant difference was observed at three months and one year postoperatively ( P  > 0.05). Conclusion K-wire-assisted PDS Nice knot fixation offers distinct advantages in managing complex comminuted patellar fractures (C3-type), including reduced operative time, effective anatomical reduction, and earlier initiation of postoperative rehabilitation, thereby improving patient satisfaction.