{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T23:35:55Z","timestamp":1775691355324,"version":"3.50.1"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"DOI":"10.1186\/s13018-025-05567-9","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T06:41:06Z","timestamp":1738910466000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Does protruding headless cannulated screw reduce fixation stability in tension band wiring technique for patella fractures? a biomechanical study"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5298-6674","authenticated-orcid":false,"given":"Mehmet","family":"Maden","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7910-3745","authenticated-orcid":false,"given":"Omer Berkay","family":"Bayraktar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8090-4370","authenticated-orcid":false,"given":"Tayfun","family":"Bacaksiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9473-7307","authenticated-orcid":false,"given":"Ihsan","family":"Akan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6638-1799","authenticated-orcid":false,"given":"Bora","family":"Uzun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2089-5043","authenticated-orcid":false,"given":"Cemal","family":"Kazimoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"5567_CR1","doi-asserted-by":"publisher","first-page":"215","DOI":"10.2106\/00004623-198062020-00007","volume":"62","author":"MJ Weber","year":"1980","unstructured":"Weber MJ, Janecki CJ, McLeod P, Nelson CL, Thompson JA. Efficacy of various forms of fixation of transverse fractures of the patella. J Bone Jt Surg - Ser A. 1980;62:215\u201320.","journal-title":"J Bone Jt Surg - Ser A"},{"key":"5567_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13018-019-1060-x","volume":"14","author":"M Ling","year":"2019","unstructured":"Ling M, Zhan S, Jiang D, Hu H, Zhang C. Where should Kirschner wires be placed when fixing patella fracture with modified tension-band wiring? A finite element analysis. J Orthop Surg Res. 2019;14:1\u20138.","journal-title":"J Orthop Surg Res"},{"key":"5567_CR3","doi-asserted-by":"publisher","unstructured":"Karadeniz E, Keskinoz EN. A comparison of EFECE systems with tension band wiring for patella fracture fixation in cadavers. J Orthop Surg Res [Internet]. 2020;15:256. Available from: https:\/\/doi.org\/10.1186\/s13018-020-01781-9","DOI":"10.1186\/s13018-020-01781-9"},{"key":"5567_CR4","doi-asserted-by":"publisher","unstructured":"Adjal J, Ban I. Patella fractures treated with suture tension band fixation. J Orthop Surg Res [Internet]. 2021;16:179. Available from: https:\/\/doi.org\/10.1186\/s13018-021-02309-5","DOI":"10.1186\/s13018-021-02309-5"},{"key":"5567_CR5","doi-asserted-by":"crossref","unstructured":"Miller MA, Liu W, Zurakowski D, Smith RM, Harris MB, Vrahas MS. Factors predicting failure of patella fixation. J Trauma Acute Care Surg [Internet]. 2012;72:1051\u20135. Available from: https:\/\/journals.lww.com\/jtrauma\/fulltext\/2012\/04000\/factors_predicting_failure_of_patella_fixation.36.aspx","DOI":"10.1097\/TA.0b013e3182405296"},{"key":"5567_CR6","doi-asserted-by":"crossref","unstructured":"Kakazu R, Archdeacon MT. Surgical Management of Patellar Fractures. Orthop Clin [Internet]. 2016 [cited 2022 Jan 20];47:77\u201383. Available from: http:\/\/www.orthopedic.theclinics.com\/article\/S0030589815001418\/fulltext","DOI":"10.1016\/j.ocl.2015.08.010"},{"key":"5567_CR7","doi-asserted-by":"crossref","unstructured":"Camarda L, Morello S, Balistreri F, D\u2019Arienzo A, D\u2019Arienzo M. Non-metallic implant for patellar fracture fixation: A systematic review. Injury [Internet]. 2016 [cited 2022 Jan 20];47:1613\u20137. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27319392\/","DOI":"10.1016\/j.injury.2016.05.039"},{"key":"5567_CR8","doi-asserted-by":"publisher","first-page":"244","DOI":"10.4055\/cios.2019.11.2.244","volume":"11","author":"BJ Lee","year":"2019","unstructured":"Lee BJ, Chon J, Yoonm JY, Jung D. Modified tension band wiring using fiberwire for patellar fractures. CiOS Clin Orthop Surg. 2019;11:244\u20138.","journal-title":"CiOS Clin Orthop Surg"},{"key":"5567_CR9","doi-asserted-by":"publisher","first-page":"e747","DOI":"10.3928\/01477447-20181010-08","volume":"41","author":"JL Henrichsen","year":"2018","unstructured":"Henrichsen JL, Wilhem SK, Siljander MP, Kalma JJ, Karadsheh MS. Treatment of patella fractures. Orthopedics. 2018;41:e747\u201355.","journal-title":"Orthopedics"},{"key":"5567_CR10","doi-asserted-by":"crossref","unstructured":"Berg EE. Open reduction internal fixation of displaced transverse patella fractures with figure-eight wiring through parallel cannulated compression screws. J Orthop Trauma [Internet]. 1997;11:573\u20136. Available from: https:\/\/journals.lww.com\/jorthotrauma\/Fulltext\/1997\/11000\/Open_Reduction_Internal_Fixation_of_Displaced.5.aspx","DOI":"10.1097\/00005131-199711000-00005"},{"key":"5567_CR11","doi-asserted-by":"crossref","unstructured":"Thelen S, Schneppendahl J, Jopen E, Eichler C, Koebke J, Sch\u00f6nau E et al. Biomechanical cadaver testing of a fixed-angle plate in comparison to tension wiring and screw fixation in transverse patella fractures. Injury [Internet]. 2012;43:1290\u20135. Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0020138312001659","DOI":"10.1016\/j.injury.2012.04.020"},{"key":"5567_CR12","doi-asserted-by":"crossref","unstructured":"Kfuri M, Escalante I, Schopper C, Zderic I, Stoffel K, Sommer C et al. Comminuted patellar fractures: The role of biplanar fixed angle plate constructs. J Orthop Transl [Internet]. 2021;27:17\u201324. Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2214031X20301157","DOI":"10.1016\/j.jot.2020.10.003"},{"key":"5567_CR13","doi-asserted-by":"publisher","first-page":"344","DOI":"10.4055\/cios20175","volume":"13","author":"GF Trinchese","year":"2021","unstructured":"Trinchese GF, Cipollaro L, Calabrese E, Maffulli N. Platelet-rich plasma, mesenchymal stem cell, and non-metallic suture-based fixation technique in a patellar fracture nonunion: a technical note and systematic review. CiOS Clin Orthop Surg. 2021;13:344\u201351.","journal-title":"CiOS Clin Orthop Surg"},{"key":"5567_CR14","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1093\/bmb\/ldt013","volume":"107","author":"MHG Heusinkveld","year":"2013","unstructured":"Heusinkveld MHG, Den Hamer A, Traa WA, Oomen PJA, Maffulli N. Treatment of transverse patellar fractures: a comparison between metallic and non-metallic implants. Br Med Bull. 2013;107:69\u201385.","journal-title":"Br Med Bull"},{"key":"5567_CR15","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1093\/bmb\/ldt020","volume":"108","author":"WA Traa","year":"2013","unstructured":"Traa WA, Oomen PJA, Den Hamer A, Heusinkveld MHG, Maffulli N. Biomechanical studies on transverse olecranon and patellar fractures: a systematic review with the development of a new scoring method. Br Med Bull. 2013;108:131\u201357.","journal-title":"Br Med Bull"},{"key":"5567_CR16","doi-asserted-by":"crossref","unstructured":"Zderic I, Stoffel K, Sommer C, H\u00f6ntzsch D, Gueorguiev B. Biomechanical evaluation of the tension band wiring principle. A comparison between two different techniques for transverse patella fracture fixation. Injury [Internet]. 2017;48:1749\u201357. Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0020138317303625","DOI":"10.1016\/j.injury.2017.05.037"},{"key":"5567_CR17","doi-asserted-by":"crossref","unstructured":"Martin JM, Applin DT, McGrady LM, Wang M, Schmeling GJ. Biomechanical Comparison of Tension Band Fixation of Patella Transverse Fracture: Headless Screws Versus Headed Screws. J Orthop Trauma [Internet]. 2019;33. Available from: https:\/\/journals.lww.com\/jorthotrauma\/fulltext\/2019\/06000\/biomechanical_comparison_of_tension_band_fixation.15.aspx","DOI":"10.1097\/BOT.0000000000001447"},{"key":"5567_CR18","doi-asserted-by":"publisher","unstructured":"Tian Y, Zhou F, Ji H, Zhang Z, Guo Y. Cannulated screw and cable are superior to modified tension band in the treatment of transverse patella fractures. Clin Orthop Relat Res [Internet]. 2011;469:3429\u201335. Available from: https:\/\/doi.org\/10.1007\/s11999-011-1913-z","DOI":"10.1007\/s11999-011-1913-z"},{"key":"5567_CR19","doi-asserted-by":"crossref","unstructured":"Dy CJ, Little MTM, Berkes MB, Ma Y, Roberts TR, Helfet DL et al. Meta-analysis of re-operation, nonunion, and infection after open reduction and internal fixation of patella fractures. J Trauma Acute Care Surg [Internet]. 2012;73:928\u201332. Available from: https:\/\/journals.lww.com\/jtrauma\/fulltext\/2012\/10000\/meta_analysis_of_re_operation,_nonunion,_and.23.aspx","DOI":"10.1097\/TA.0b013e31825168b6"},{"key":"5567_CR20","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1097\/00005131-199704000-00008","volume":"11","author":"ST Smith","year":"1997","unstructured":"Smith ST, Cramer KE, Karges DE, Watson JT, Moed BR. Early complications in the Operative treatment of Patella fractures. J Orthop Trauma. 1997;11:183\u20137.","journal-title":"J Orthop Trauma"},{"key":"5567_CR21","doi-asserted-by":"crossref","unstructured":"Blum L, Hake M. ORIF Patella Fracture With a Tension Band Construct. J Orthop Trauma [Internet]. 2017;31:S8\u20139. Available from: https:\/\/journals.lww.com\/jorthotrauma\/fulltext\/2017\/08003\/orif_patella_fracture_with_a_tension_band.5.aspx","DOI":"10.1097\/BOT.0000000000000891"},{"key":"5567_CR22","doi-asserted-by":"crossref","unstructured":"Qi L, Chang C, Xin T, Xing PF, Tianfu Y, Gang Z et al. Double fixation of displaced patella fractures using bioabsorbable cannulated lag screws and braided polyester suture tension bands. Injury [Internet]. 2011;42:1116\u201320. Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0020138311000301","DOI":"10.1016\/j.injury.2011.01.025"},{"key":"5567_CR23","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/00005131-199707000-00009","volume":"11","author":"JE Carpenter","year":"1997","unstructured":"Carpenter JE, Kasman RA, Patel N, Lee ML, Goldstein SA. Biomechanical evaluation of current patella fracture fixation techniques. J Orthop Trauma. 1997;11:351\u20136.","journal-title":"J Orthop Trauma"},{"key":"5567_CR24","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1007\/s00264-008-0602-3","volume":"33","author":"O Baran","year":"2009","unstructured":"Baran O, Manisali M, Cecen B. Anatomical and biomechanical evaluation of the tension band technique in patellar fractures. Int Orthop. 2009;33:1113\u20137.","journal-title":"Int Orthop"},{"key":"5567_CR25","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1097\/CORR.0000000000000683","volume":"477","author":"MC Avery","year":"2019","unstructured":"Avery MC, Jo S, Chang A, Ricci WM, McAndrew C, Miller AN, et al. Cannulated screw prominence in Tension Band Wiring of Patella fractures increases fracture gapping: a cadaver study. Clin Orthop Relat Res. 2019;477:1249\u201355.","journal-title":"Clin Orthop Relat Res"},{"key":"5567_CR26","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.clinbiomech.2009.12.010","volume":"25","author":"M Wild","year":"2010","unstructured":"Wild M, Eichler C, Thelen S, Jungbluth P, Windolf J, Hakimi M. Fixed-angle plate osteosynthesis of the patella - an alternative to tension wiring? Clin Biomech. 2010;25:341\u20137.","journal-title":"Clin Biomech"},{"key":"5567_CR27","doi-asserted-by":"publisher","unstructured":"Thelen S, Schneppendahl J, Baumg\u00e4rtner R, Eichler C, Koebke J, Betsch M et al. Cyclic long-term loading of a bilateral fixed-angle plate in comparison with tension band wiring with K-wires or cannulated screws in transverse patella fractures. Knee Surgery, Sport Traumatol Arthrosc [Internet]. 2013;21:311\u20137. Available from: https:\/\/doi.org\/10.1007\/s00167-012-1999-1","DOI":"10.1007\/s00167-012-1999-1"},{"key":"5567_CR28","doi-asserted-by":"publisher","unstructured":"Lee KH, Lee Y, Lee YH, Cho BW, Kim MB, Baek GH. Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins. J Orthop Surg [Internet]. 2019;27:2309499019882140. Available from: https:\/\/doi.org\/10.1177\/2309499019882140","DOI":"10.1177\/2309499019882140"},{"key":"5567_CR29","first-page":"162","volume":"90","author":"W Brill","year":"1987","unstructured":"Brill W, Hopf T. Biomechanical study of various osteosynthesis procedures in transverse patella fractures. Unfallchirurg. 1987;90:162\u201372.","journal-title":"Unfallchirurg"},{"key":"5567_CR30","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/S0003-9993(97)90030-7","volume":"78","author":"NA Sharkey","year":"1997","unstructured":"Sharkey NA, Donahue SW, Smith TS, Bay BK, Marder RA. Patellar strain and patellofemoral contact after bone-patellar tendon- bone harvest for anterior cruciate ligament reconstruction. Arch Phys Med Rehabil. 1997;78:256\u201363.","journal-title":"Arch Phys Med Rehabil"},{"key":"5567_CR31","doi-asserted-by":"crossref","unstructured":"Burvant JG, Thomas KA, Alexander R, Harris MB. Evaluation of methods of internal fixation of transverse patella fractures: a biomechanical study. J Orthop Trauma. 1994. pp. 147\u201353.","DOI":"10.1097\/00005131-199404000-00012"},{"key":"5567_CR32","doi-asserted-by":"crossref","unstructured":"Scilaris TA, Grantham JL, Prayson MJ, Marshall MP, Hamilton JJ, Williams JL. Biomechanical comparison of fixation methods in transverse Patella fractures. J Orthop Trauma. 1998. pp. 356\u20139.","DOI":"10.1097\/00005131-199806000-00011"},{"key":"5567_CR33","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1302\/0301-620X.89B12.19671","volume":"89","author":"MS Gaston","year":"2007","unstructured":"Gaston MS, Simpson AHRW. Inhibition of fracture healing. J Bone Jt Surg - Ser B. 2007;89:1553\u201360.","journal-title":"J Bone Jt Surg - Ser B"},{"key":"5567_CR34","doi-asserted-by":"crossref","unstructured":"Meeson R, Moazen M, Sanghani-Kerai A, Osagie-Clouard L, Coathup M, Blunn G. The influence of gap size on the development of fracture union with a micro external fixator. J Mech Behav Biomed Mater [Internet]. 2019;99:161\u20138. Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1751616119303625","DOI":"10.1016\/j.jmbbm.2019.07.015"},{"key":"5567_CR35","doi-asserted-by":"publisher","first-page":"647","DOI":"10.2106\/00004623-198668050-00003","volume":"68","author":"JL Knirk","year":"1986","unstructured":"Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68:647\u201359.","journal-title":"J Bone Joint Surg Am"},{"key":"5567_CR36","doi-asserted-by":"crossref","unstructured":"Bulut T, Gursoy M. Isolated Medial Malleolus Fractures: Conventional Techniques Versus Headless Compression Screw Fixation. J Foot Ankle Surg [Internet]. 2018;57:552\u20136. Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1067251617306993","DOI":"10.1053\/j.jfas.2017.12.005"},{"key":"5567_CR37","first-page":"90","volume":"28","author":"M Ulu\u00f6z","year":"2024","unstructured":"Ulu\u00f6z M, G\u00f6kmen MY. Intramedullary locking mini-plate screw system in Lindgren osteotomy: a more effective fixation technique in mild and moderate hallux valgus cases. Eur Rev Med Pharmacol Sci. 2024;28:90\u20137.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"5567_CR38","doi-asserted-by":"publisher","unstructured":"Chen CH, Chen YN, Li CT, Chang CW, Chang CH, Peng Y, Te. Roles of the screw types, proximity and anterior band wiring in the surgical fixation of transverse patellar fractures: A finite element investigation. BMC Musculoskelet Disord [Internet]. 2019;20:99. Available from: https:\/\/doi.org\/10.1186\/s12891-019-2474-7","DOI":"10.1186\/s12891-019-2474-7"},{"key":"5567_CR39","doi-asserted-by":"crossref","unstructured":"Malik M, Halwai MAhma. Open reduction and internal fixation of patellar fractures with tension band wiring through cannulated screws. J Knee Surg [Internet]. 2014\/01\/10. 2014;27:377\u201382. Available from: http:\/\/www.thieme-connect.com\/products\/ejournals\/abstract\/10.1055\/s-0033-1364100","DOI":"10.1055\/s-0033-1364100"},{"key":"5567_CR40","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1177\/107110070202300806","volume":"23","author":"JI Acevedo","year":"2002","unstructured":"Acevedo JI, Sammarco VJ, Boucher HR, Parks BG, Schon LC, Myerson MS. Mechanical comparison of cyclic loading in five different first metatarsal shaft osteotomies. Foot Ankle Int. 2002;23:711\u20136.","journal-title":"Foot Ankle Int"}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-025-05567-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13018-025-05567-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-025-05567-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T06:41:15Z","timestamp":1738910475000},"score":1,"resource":{"primary":{"URL":"https:\/\/josr-online.biomedcentral.com\/articles\/10.1186\/s13018-025-05567-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,7]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5567"],"URL":"https:\/\/doi.org\/10.1186\/s13018-025-05567-9","relation":{},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,7]]},"assertion":[{"value":"5 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All methods were carried out in accordance with relevant guidelines and regulations. This study was performed in line with the principles of the Declaration of Helsinki. Ethics approval was obtained by the Izmir Katip Celebi University Atat\u00fcrk Training and Research Hospital Non-Interventional Clinical Studies Institutional Review Board (No: 0011).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. This is a biomechanical study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors declare that they have no conflict of interest.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"148"}}