“Net cage” technique in the treatment of inferior pole patella fracture

TL;DR

A new surgical technique called 'Net cage' was used to treat patella fractures, showing good healing and knee function with minimal complications.

Contribution

The 'Net cage' technique is introduced as a novel fixation method for inferior pole patella fractures.

Findings

All patients achieved smooth fracture healing without fixation failure or implant fracture.

The average knee joint range of motion was 133.75° with favorable Bostman scores.

The technique reduced fluoroscopy times and avoided soft tissue irritation.

Abstract

: Fractures of the inferior pole of the patella can cause disorders of the knee joint extensor mechanism. The fracture fragments are usually small and comminuted, presenting certain difficulties in fixation. The purpose of this study is to observe the clinical effect of the “Net cage” technique in the treatment of inferior pole patella fractures.

This is a retrospective study that included 16 cases of inferior patella fractures (AO/OTA 34-A1) who underwent the “Net cage” technique from March 2017 to June 2020. Their medical records and follow-up results were collected, and the measured indicators included surgical complications related to the fixation method, knee joint function, the number of fluoroscopies, fracture healing, and the incidence of soft tissue stimulation.

All patients achieved smooth fracture healing without complications such as internal fixation failure or implant fracture. The average number of intraoperative fluoroscopies was 5.56 ± 1.82 times (range: 4–10 times); the average fracture healing time was 10.5 ± 1.96 weeks (range: 8–14 weeks). No patients reported internal fixation-related soft tissue irritation. At the last follow-up, the knee joint function evaluation showed that the average range of motion (ROM) was 133.75 ± 5.89° (range: 120°∼140°); the average Bostman score was 27.94 ± 1.83 points (range: 24–30 points). Due to the small sample size of this study, only descriptive statistical analysis was performed on the data.

The “Net cage” technique for the treatment of inferior pole patella fractures shows promising short- to mid-term results, with the potential advantages of reducing fluoroscopy times, providing stable fixation, facilitating early functional exercise, and achieving favorable postoperative knee joint function. However, given the limitations of the study design, the clinical application and advantages of this technique require further verification by large-sample, multi-center randomized controlled studies.

Figures