Locking plate fixation compared with tension-band wiring for patellar fractures: a multicentre randomized controlled trial.
Bone Joint JSep 1, 2026 (epub)
Clinical ResearchOrthopedic Surgery
Peter Larsen, Rikke Thorninger, Rasmus Pind Severinsen et al.
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In 30 seconds
This multicentre randomized controlled trial compared locking plate fixation with tension-band wiring in 122 adults with displaced patellar fractures. At 12 months, locking plate fixation showed statistically significant improvements in three KOOS sub-scales: symptoms (mean difference -10.4), sport and recreation (-14.1), and quality of life (-10.9), indicating superior patient-reported outcomes.
Key findings
- Locking plate fixation improved symptoms by a mean difference of -10.4.
- Patients reported a mean difference of -14.1 in sport and recreation with locking plate fixation.
- Quality of life scores improved by a mean difference of -10.9 with locking plate fixation.
- Tension-band wiring had higher rates of hardware removal, fixation failure, and reoperation.
Why it matters
The findings suggest that locking plate fixation may lead to better functional outcomes and lower complication rates compared to traditional tension-band wiring, which is crucial for optimizing recovery in patients with patellar fractures.