Comparison of a minimally invasive osteosynthesis technique with open surgical technique for transverse patellar fractures

This retrospective study aimed to compare the safety and efficacy of a new minimally invasive osteosynthesis technique with those of conventional open surgery for transverse patellar fractures. Between January 2016 and December 2022, a total of 138 patients with transverse patellar fractures who underwent osteosynthesis with either minimally invasive osteosynthesis technique (MIOT) or open reduction and internal fixation (ORIF) were enrolled and retrospectively analyzed. The outcomes were assessed for 67 patients in the MIOT group (mean age: 46.2 ± 15.8 years old, mean follow-up: 26.4 ± 5.1 months) and 51 patients in the ORIF group (mean age: 43.7 ± 13.4 years old, mean follow-up: 25.1 ± 4.8 months). Clinical outcomes, including surgical time, blood loss, bony union time, final range of motion involving knee extension and flexion, Bostman score, visual analogue scale (VAS), and complications, were measured over a minimum follow-up period of 24 months. The surgical time in the MIOT group was shorter than that in the ORIF group (P = .001). The blood loss in the MIOT group was significantly less than that in the ORIF group (P < .0001). At the 2-year follow-up, all fractures had healed. The mean union time in the MIOT group was shorter than that in the ORIF group (P = .002). The MIOT group also exhibited significantly better flexion (P = .001) and a higher Bostman score (P = .0065), compared with the ORIF group. The mean VAS was significantly lower in the MIOT group than that in the ORIF group (P < .0001). The MIOT group had a lower complication rate, including delayed wound healing and implant irritation, as well as an overall lower complication rate. The MIOT method proved to be a reproducibly reliable approach, offering lower surgical trauma, improved functional outcomes, and a lower incidence of complications compared with the conventional open surgical technique for transverse patellar fractures. It may be a prudent choice for treating transverse patellar fractures.