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ORIGINAL RESEARCH article

Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1530745
This article is part of the Research Topic Biomechanics in Orthopaedic Diseases and Surgery, Volume II View all 7 articles

Dual Tension Band Technique for Patellar Fractures Involving Articular Surface and Inferior Pole: A Retrospective Cohort Study and Finite Element Analysis

Provisionally accepted
Yanchun Gao Yanchun Gao 1Guifa Wu Guifa Wu 2*Hongli Zhu Hongli Zhu 3*Kaixin Bian Kaixin Bian 1*Di Wu Di Wu 1*Haifeng Wei Haifeng Wei 1*
  • 1 Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
  • 2 Jiuting Hospital, Songjiang District, Shanghai, Shanghai, China
  • 3 Chongqing Optical Machinery Research Institute, Chongqing, China

The final, formatted version of the article will be published soon.

    Fractures involving the inferior pole of the patella can lead to postoperative patella baja. For comminuted patellar fractures that affect both the articular surface and the inferior pole, we aim to explore a new fixation method that provides reliable internal stabilization while reducing the incidence of patella baja.We conducted a finite element biomechanical study and a retrospective cohort clinical study. The finite element analysis compared the "dual tension band" technique to the traditional single tension band method using 3D models of patellar fractures. The clinical study included 66 patients with patellar fractures involving the articular surface and inferior pole, divided into two groups based on the fixation method. Outcomes were assessed using a range of motion (ROM), Böstman scores, and the Insall-Salvati Index (ISI).The finite element analysis revealed that the dual tension band technique resulted in lower maximum stress on the patella and lower displacement on the fixation devices compared to the single tension band. Clinically, patients treated with the dual tension band had significantly higher postoperative ISI values (0.93±0.16 vs. 0.85±0.17, p<0.05), better ROM (123.75±9.58 vs. 117.63±12.28, p<0.05), and a lower incidence of patella baja (17.86% vs. 34.21%). The Böstman scores showed no significant difference between the groups.The dual tension band technique provides effective stabilization for patellar fractures involving the articular surface and inferior pole, reducing the incidence of postoperative patella baja and improving functional outcomes.

    Keywords: Patellar fracture, Inferior pole of the patella, Patella baja, Insall-Salvati index, Finite Element Analysis

    Received: 19 Nov 2024; Accepted: 31 Jan 2025.

    Copyright: © 2025 Gao, Wu, Zhu, Bian, Wu and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Guifa Wu, Jiuting Hospital, Songjiang District, Shanghai, Shanghai, China
    Hongli Zhu, Chongqing Optical Machinery Research Institute, Chongqing, China
    Kaixin Bian, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
    Di Wu, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
    Haifeng Wei, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China

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