ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1594907
This article is part of the Research TopicSurgical Advances in Orthopedic Trauma: A Biomechanical ApproachView all 11 articles
Comparative Clinical Outcomes of Dual Cannulated Screw-Cable System versus Kirschner Wire-Cable Fixation in Type C Patellar Fractures
Provisionally accepted
- China-Japan Friendship Hospital, Beijing, China
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To compare the clinical efficacy and safety of the dual cannulated screw-cable (DCSC) system with those of conventional Kirschner wire-cable (KWC) fixation in the management of patellar fractures.This study aims to fill this gap by evaluating functional recovery, radiographic union, and complication rates between the two fixation methods. Methods: This retrospective cohort study included 127 patients with patellar fractures (AO/OTA 34-C) treated between January 2020 and December 2023. The patients were stratified into DCSC (n=26) and KWC (n=101) groups. The primary outcomes included functional recovery (Lysholm and Böstman scores) at 3 and 12 months postoperatively. Results: The DCSC group demonstrated superior short-term functional outcomes, with significantly higher Lysholm scores at 3 months (76.0 ± 6.1 vs. 70.4 ± 2.9, p < 0.001) and significantly higher Böstman scores across all fracture classifications (C1: 21.5 vs. 17.5; C2: 21.6 vs. 17.2; C3: 21.3 vs. 17.6; all p < 0.001). Notably, C2 fractures treated with DCSC exhibited the greatest improvement in Lysholm scores (at 3 months, p < 0.001). DCSC also resulted in shorter operative times (62.9 ± 1.8 vs. 76.0 ± 1.4 minutes, p < 0.001) and reduced symptomatic hardware irritation (3.8% vs. 21.8%, p = 0.03). Radiographic union was faster in the DCSC group (3.04 vs. 3.50 months, p < 0.001). However, the Lysholm and Böstman scores at 12 months were similar between the groups (p > 0.05), and the reoperation rates at 12 months were comparable (3.8% vs. 2.0%, p = 0.82). Conclusion: Compared with KWC fixation, the DCSC system provides superior early functional recovery, fewer complications, and faster fracture healing, particularly in complex intra-articular fractures (OTA 34-C2). However, the benefits of the DCSC system in simpler or more comminuted fracture (C1/C3) diminish over time, and caution is warranted when using this system in comminuted or distal coronal plane fractures owing to potential compression limitations. These findings support the use of DCSC as a first-line option for C2 fractures, although long-term studies are needed to assess implant durability.
Keywords: Patellar fracture, dual cannulated screw-cable system, Kirschner wire-cable fixation, functional outcomes, hardware irritation 1. Introduction
Received: 17 Mar 2025; Accepted: 15 Aug 2025.
Copyright: © 2025 Yang, Yuan, Shi, Si, Liu, Chen and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaodong Xu, China-Japan Friendship Hospital, Beijing, China
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