Comparison of Functional Outcomes of Comminuted and Simple Patellar Fractures Treated with Tension Band Wiring

Aim: This study aimed to compare the functional outcomes of comminuted (AO/OTA C3) patellar fractures treated with tension band wiring technique to those of simple two-part fractures (AO/OTA C1) treated with the same method. Methods: Patients who underwent surgery for patellar fractures between 2017 and 2023 were retrospectively analyzed. A total of 83 patients met the inclusion criteria (C1: n=45; C3: n=38). All patients underwent open reduction and internal fixation with the tension band wiring technique. Functional outcomes were evaluated using the Böstman score. Statistical analysis was performed with SPSS 20.0 software. Results: There was no statistically significant difference between the groups in terms of age, sex, side, follow-up duration, or implant removal rates (p>0.05). The mean Böstman score was significantly higher in the C1 group (23.33±5.07) compared to the C3 group (19.58±6.48; p=0.005), indicating better functional outcomes in the simpler fracture type. Conclusion: The tension band wiring technique yields satisfactory results in simple two-part patellar fractures. However, it may be insufficient for comminuted fractures, suggesting a need for evaluating alternative surgical fixation techniques for such cases.