Comparison of Functional Results and Complications Between K-Wire Tension Band Fixation and Interosseous Suturing in Transverse Patellar Fractures: A Randomized Controlled Trial

K-wire tension band wiring for transverse patellar fracture fixation.

Surgical fixation of an acute transverse patellar fracture using Kirschner wires (K-wires) and a tension band construct to stabilize the fracture and maintain reduction during bone healing.

Transosseous suture fixation using No. 5 FiberWire for transverse patellar fracture fixation.

Surgical fixation of an acute transverse patellar fracture using transosseous bone tunnels and high-strength No. 5 FiberWire sutures to stabilize the fracture and maintain reduction during bone healing.

Functional outcome will be assessed using the Böstman Patellar Fracture Score, a validated scoring system for evaluating functional recovery following patellar fractures. The scale ranges from 0 to 30 points, with a minimum score of 0 and a maximum score of 30. Higher scores indicate better functional outcomes, whereas lower scores indicate poorer functional recovery.

Pain severity will be assessed using the Visual Analog Scale (VAS), a 10-cm scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain severity and worse outcomes, whereas lower scores indicate less pain and better outcomes.

Knee range of motion will be assessed by measuring active knee flexion and extension using a standard goniometer. Measurements will be recorded in degrees (°). Knee flexion ranges from 0° to 140°, with higher flexion values indicating greater knee mobility and better functional recovery. Knee extension is assessed by measuring the degree of extension deficit, where 0° indicates full extension and higher deficit values indicate worse outcomes.

Time to fracture union will be assessed in weeks from the date of surgery until radiographic evidence of fracture union is achieved. Fracture union will be defined by radiographic evidence of bridging bone across at least three of the four cortices on orthogonal radiographic views, in conjunction with clinical evidence of healing. The minimum value is 0 weeks. Higher values indicate a longer time to fracture union and therefore a worse outcome, whereas lower values indicate faster fracture healing and a better outcome.

Postoperative complications will be assessed by recording the occurrence of any complications following surgery, including surgical site infection, wound complications, implant-related complications (such as K-wire migration, wire breakage, or fixation failure), loss of fracture reduction, nonunion, delayed union, symptomatic hardware, and reoperation. The outcome will be recorded as a binary variable: 0 = No postoperative complications and 1 = At least one postoperative complication. The minimum value is 0 and the maximum value is 1. Higher scores indicate the occurrence of postoperative complications and therefore worse outcomes.