This study aimed to introduce and provide a preliminary clinical evaluation of a novel all-titanium “cable-net” construct, which combines vertical and circumferential cables, for the treatment of inferior pole patellar fractures . A retrospective analysis was conducted on 23 patients with closed inferior pole fractures treated with the “cable-net” fixation between January 2021 and January 2025. The surgical technique involved placing three vertical titanium cables (Ø 1.3 mm) through longitudinal bone tunnels and one circumferential titanium cable around the patella, creating a unified containment construct. An accelerated rehabilitation protocol was followed postoperatively. Outcomes were assessed using the Böstman functional score, active knee range of motion (ROM), the Insall-Salvati Index (ISI), and complication rates. All fractures achieved radiographic union with a mean follow-up of 16.3 ± 3.6 months. The mean Böstman score was 29.7 ± 0.6, and the mean active knee ROM was 132.8° ± 3.3°. The mean postoperative ISI was 0.99 ± 0.08, with no cases of patella baja (ISI < 0.8) observed. Complications were minimal, with only one superficial surgical site infection recorded. No instances of implant failure, loss of reduction, or symptomatic hardware irritation requiring early removal occurred. The all-titanium “cable-net” construct provided stable fixation for comminuted inferior pole patellar fractures, facilitating excellent functional recovery, maintaining normal patellar height, and demonstrating a low complication profile. This technique appears to be a feasible and safe technique for treating comminuted inferior pole patellar fractures in this small retrospective series.
Shi et al. (Fri,) studied this question.