{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T06:43:38Z","timestamp":1778222618030,"version":"3.51.4"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Innovation Fund of the National Clinical Research Center for Orthopedics and Sports Medicine","award":["Project No. 2021-NCRC-CXJJ-PY-02"],"award-info":[{"award-number":["Project No. 2021-NCRC-CXJJ-PY-02"]}]},{"name":"the Science and Technology Plan Project of Shenyang City","award":["Project No. 22-321-32-13"],"award-info":[{"award-number":["Project No. 22-321-32-13"]}]},{"name":"Science and Technology Fund of the education department of Liaoning province","award":["Project No.2024"],"award-info":[{"award-number":["Project No.2024"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purposes<\/jats:title>\n<jats:p>Fractures of the inferior patellar pole, unlike other patellar fractures, present challenges for traditional surgical fixation methods. This article introduces the clinical technique and outcomes of using Kirschner wire tension band combined with anchor screw cross-stitch fixation for comminuted inferior patellar pole fractures.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective case series study included 14 patients with comminuted inferior patellar pole fractures treated at our institution from September 1, 2020, to April 30, 2022. All patients underwent surgery using the Kirschner wire tension band with anchor screw cross-stitch technique. Follow-up assessments involved postoperative X-rays to evaluate fracture healing, as well as clinical parameters such as healing time, Visual Analog Scale (VAS) scores, range of motion (ROM), and Bostman scores.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>All patients were followed for an average of over 12 months, with no cases of internal fixation failure. Knee joint stability and function were excellent. X-rays revealed an average healing time of approximately 10.79 \u00b1 1.53 weeks, hospitalization lasted 5.64 \u00b1 1.15 days, surgery took approximately 37.86 \u00b1 5.32 minutes, and intraoperative blood loss was 33.29 \u00b1 8.15 ml. One patient experienced irritation from the internal fixation material. At the final follow-up, the Bostman score averaged 28.29 \u00b1 0.83, knee joint flexion reached 131.07\u00b0 \u00b1 4.88\u00b0, all patients achieved full knee extension, and the VAS score was 0.36 \u00b1 0.63.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Kirschner wire tension band with anchor screw cross-stitch fixation for comminuted inferior patellar pole fractures delivered satisfactory clinical outcomes. This surgical method, characterized by its simplicity and reliability, is a valuable addition to clinical practice.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302839","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T17:39:35Z","timestamp":1714671575000},"page":"e0302839","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Study on the therapeutic effect of Kirschner wire tension band combined with anchor cross-stitch technique in the treatment of comminuted patellar inferopolar fractures"],"prefix":"10.1371","volume":"19","author":[{"given":"SiYu","family":"Duan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HaiRui","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RongDa","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanfei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"XueTing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3362-1926","authenticated-orcid":true,"given":"ZhenCun","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"pone.0302839.ref001","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1093\/bmb\/ldt013","article-title":"Treatment of transverse patellar fractures: a comparison between metallic and non-metallic implants","volume":"107","author":"MHG Heusinkveld","year":"2013","journal-title":"Br Med Bull"},{"key":"pone.0302839.ref002","first-page":"4964195","article-title":"Clinical Effect of Suture Anchor and Double-Pulley Technique in the Treatment of Inferior Patellar Fracture","volume":"2021","author":"H Yu","year":"2021","journal-title":"Comput Math Methods Med"},{"key":"pone.0302839.ref003","first-page":"w20165","article-title":"Practical guidelines for the treatment of patellar fractures in adults","volume":"150","author":"S Steinmetz","year":"2020","journal-title":"Swiss Med Wkly"},{"issue":"2","key":"pone.0302839.ref004","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s00402-017-2807-7","article-title":"Comminuted inferior pole fracture of patella can be successfully treated with rim-plate-augmented separate vertical wiring","volume":"138","author":"J-W Cho","year":"2018","journal-title":"Arch Orthop Trauma Surg"},{"issue":"2","key":"pone.0302839.ref005","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1111\/os.13124","article-title":"Anchor and Krackow-\"8\" Suture for the Fixation of Distal Pole Fractures of the Patella: Comparison to Kirschner Wire","volume":"14","author":"J Xie","year":"2022","journal-title":"Orthop Surg"},{"issue":"2","key":"pone.0302839.ref006","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0020-1383(00)00170-4","article-title":"Clinical experience of patellar fracture fixation using metal wire or non-absorbable polyester\u2014a study of 37 cases","volume":"32","author":"HS Gosal","year":"2001","journal-title":"Injury"},{"issue":"1","key":"pone.0302839.ref007","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s00264-015-2776-9","article-title":"Anchor suture fixation of distal pole fractures of patella: twenty seven cases and comparison to partial patellectomy","volume":"40","author":"A Kadar","year":"2016","journal-title":"Int Orthop"},{"issue":"12","key":"pone.0302839.ref008","doi-asserted-by":"crossref","first-page":"2512","DOI":"10.1016\/j.injury.2015.09.026","article-title":"Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing","volume":"46","author":"H-K Oh","year":"2015","journal-title":"Injury"},{"issue":"Suppl 6","key":"pone.0302839.ref009","doi-asserted-by":"crossref","first-page":"S87","DOI":"10.1016\/j.injury.2015.10.068","article-title":"Internal fixation of patellar apex fractures with the basket plate: 25 years of experience","volume":"46","author":"A Matej\u010di\u0107","year":"2015","journal-title":"Injury"},{"issue":"3","key":"pone.0302839.ref010","doi-asserted-by":"crossref","first-page":"333","DOI":"10.4103\/0019-5413.65149","article-title":"Role of suture anchors in management of fractures of inferior pole of patella","volume":"44","author":"A Anand","year":"2010","journal-title":"Indian J Orthop"},{"issue":"2","key":"pone.0302839.ref011","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1111\/os.12876","article-title":"Novel Rim Plating Technique for Treatment of the Inferior Pole Fracture of the Patella","volume":"13","author":"Q-F He","year":"2021","journal-title":"Orthop Surg"},{"issue":"10","key":"pone.0302839.ref012","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2106\/JBJS.RVW.17.00172","article-title":"Treatment of Patellar Fractures and Injuries to the Extensor Mechanism of the Knee: A Critical Analysis Review","volume":"6","author":"CN Bui","year":"2018","journal-title":"JBJS Rev"},{"issue":"11","key":"pone.0302839.ref013","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/j.injury.2009.04.011","article-title":"FiberWire is superior in strength to stainless steel wire for tension band fixation of transverse patellar fractures","volume":"40","author":"PB Wright","year":"2009","journal-title":"Injury"},{"issue":"11","key":"pone.0302839.ref014","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1007\/s00402-020-03671-5","article-title":"Suture anchor fixation of comminuted inferior pole patella fracture-novel technique: suture bridge anchor fixation technique","volume":"141","author":"K-S Kim","year":"2021","journal-title":"Arch Orthop Trauma Surg"},{"issue":"3","key":"pone.0302839.ref015","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.injury.2020.01.028","article-title":"Combination of a miniplate with tension band wiring for inferior patellar pole avulsion fractures","volume":"51","author":"W Zhu","year":"2020","journal-title":"Injury"},{"issue":"Pt 1","key":"pone.0302839.ref016","first-page":"113","article-title":"Inferior patellar pole avulsion fractures: osteosynthesis compared with pole resection. Surgical technique","volume":"87 Suppl 1","author":"M Veselko","year":"2005","journal-title":"J Bone Joint Surg Am"},{"key":"pone.0302839.ref017","first-page":"63","article-title":"Patella fracture fixation with suture and wire: you reap what you sew","volume":"34","author":"K Egol","year":"2014","journal-title":"Iowa Orthop J"},{"issue":"6","key":"pone.0302839.ref018","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s00264-010-1105-6","article-title":"The management of nonunion and delayed union of patella fractures: a systematic review of the literature","volume":"35","author":"ST Nathan","year":"2011","journal-title":"Int Orthop"},{"issue":"4","key":"pone.0302839.ref019","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00402-008-0572-3","article-title":"Multifragment fracture of the patellar apex: basket plate osteosynthesis compared with partial patellectomy","volume":"128","author":"A Matejci\u0107","year":"2008","journal-title":"Arch Orthop Trauma Surg"},{"issue":"1","key":"pone.0302839.ref020","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s10195-015-0359-6","article-title":"FiberWire tension band for patellar fractures","volume":"17","author":"L Camarda","year":"2016","journal-title":"J Orthop Traumatol"},{"issue":"8","key":"pone.0302839.ref021","doi-asserted-by":"crossref","first-page":"23259671211022245","DOI":"10.1177\/23259671211022245","article-title":"Suture Anchor Versus Transosseous Tunnel Repair for Inferior Pole Patellar Fractures Treated With Partial Patellectomy and Tendon Advancement: A Biomechanical Study","volume":"9","author":"R O\u2019Donnell","year":"2021","journal-title":"Orthop J Sports Med"},{"issue":"11","key":"pone.0302839.ref022","doi-asserted-by":"crossref","first-page":"3092","DOI":"10.1111\/os.13518","article-title":"A Novel Technique for the Treatment of Inferior Pole Fractures of the Patella: A Preliminary Report","volume":"14","author":"Z Gao","year":"2022","journal-title":"Orthop Surg"},{"issue":"3","key":"pone.0302839.ref023","doi-asserted-by":"crossref","first-page":"785","DOI":"10.3349\/ymj.2014.55.3.785","article-title":"Separate vertical wiring for the fixation of comminuted fractures of the inferior pole of the patella","volume":"55","author":"HK Song","year":"2014","journal-title":"Yonsei Medical Journal"},{"issue":"7","key":"pone.0302839.ref024","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1007\/s00296-016-3449-8","article-title":"Clinical and prognostic characteristics of 158 cases of relapsing polychondritis in China and review of the literature","volume":"36","author":"D-F Lin","year":"2016","journal-title":"Rheumatol Int"},{"issue":"8","key":"pone.0302839.ref025","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1016\/j.injury.2016.06.018","article-title":"Treating patella fractures with a fixed-angle patella plate-A prospective observational study","volume":"47","author":"M Wild","year":"2016","journal-title":"Injury"},{"issue":"Suppl 1","key":"pone.0302839.ref026","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1016\/S0020-1383(18)30304-8","article-title":"Treating patella fractures with a locking patella plate\u2014first clinical results","volume":"49","author":"S Wurm","year":"2018","journal-title":"Injury"},{"issue":"1","key":"pone.0302839.ref027","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13018-019-1060-x","article-title":"Where should Kirschner wires be placed when fixing patella fracture with modified tension-band wiring? A finite element analysis","volume":"14","author":"M Ling","year":"2019","journal-title":"J Orthop Surg Res"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T17:39:55Z","timestamp":1714671595000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302839"}},"subtitle":[],"editor":[{"given":"Ashraful","family":"Hoque","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,5,2]]},"references-count":27,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0302839","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,2]]}}}