Biomechanical comparison of two tension band wiring techniques fortransverse patella fracture fixation: an in vitro study of 3-D printing models

D. Sáez Martínez, J.C. del Real-Romero, E. Calvo Crespo, F. López-Oliva Muñoz

International Biomechanics Vol. 12, nº. 1, pp. 58 - 65

Summary:

Patella fractures are relatively rare, though effective treatment of these fractures isessential. Screws and cerclage cable have been proposed to treat displaced patellarfractures to overcome the disadvantages of the modified tension band technique. Theaim of the present study was to compare the in vitro biomechanical behaviour ofa surgical construct consisting of screws and cable cerclage figure-of-eight tensionband against the classic tension band technique using a specifically designed3-D printed model of patella fracture. The patellar-fracture fixation systems tested inthe current study consisted of screws and cerclage cable tension band compared toa conventional modified AO (Association of Osteosynthesis) tension band. Each systemwas tested in ten 3D- printed patella – fracture models. Two trials were designed toreproduce the forces the patella withstands throughout the range of knee motion.Differences between forces and displacement were explored with the Student t test. Inthe extension test, the between-group difference of the force required for failure was1455,9 N greater in the screw cerclage cable setup in the flexion test, the screw cerclagegroup showed lower fracture displacement (1,42 mm less displacement) at higher forces(more than 244,9 N) compared to the Modified AO tension band. Differences were foundto be statistically significant. Screws and cerclage cable are an alternative to conven-tional surgical procedures for transverse patellar fractures. Further research must estab-lish if this setup and new non metallic materials should become the surgical treatmentgold standard.

Keywords: Patella fracture; modifiedtension band; cannulatedscrew; cerclage cable

DOI reference: https://doi.org/10.1080/23335432.2025.2562270

Published on paper: December 2025.

Published on-line: September 2025.

Citation:
D. Sáez Martínez, J.C. del Real-Romero, E. Calvo Crespo, F. López-Oliva Muñoz, "Biomechanical comparison of two tension band wiring techniques fortransverse patella fracture fixation: an in vitro study of 3-D printing models", International Biomechanics, Vol. 12, nº. 1, pp. 58 - 65, December 2025. [Online: September 2025] doi: 10.1080/23335432.2025.2562270