PMID- 37872511
OWN - NLM
STAT- MEDLINE
DCOM- 20231027
LR  - 20231123
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 24
IP  - 1
DP  - 2023 Oct 23
TI  - Candy box technique for the fixation of inferior pole patellar fractures: finite 
      element analysis and biomechanical experiments.
PG  - 835
LID - 10.1186/s12891-023-06946-1 [doi]
LID - 835
AB  - BACKGROUND: Maintaining effective reduction and firm fixation in inferior pole 
      patellar fractures is a highly challenging task. There are various treatment 
      methods available; although tension-band wiring combined with cerclage wiring 
      (TBWC) is the mainstream approach, its effectiveness is limited. Herein, we 
      propose and evaluate a new technique called candy box (CB), based on separate 
      vertical wiring (SVW), for the treatment of inferior pole patellar fractures. 
      Specifically, we provide biomechanical evidence for its clinical application. 
      METHODS: Five fixation models were built: SVW combined with cerclage wiring 
      (SVWC); TBWC; modified SVW with the middle (MSVW-A) or upper (MSVW-B) 1/3 of the 
      steel wire reserved, and CB. A finite element analysis was performed to compare 
      the displacement and stress under 100-N, 200-N, 300-N, 400-N and 500-N force 
      loads. Three-dimensional printing technology was utilized to create fracture 
      models, and the average displacement of each model group was compared under a 
      500-N force. RESULTS: The results of the finite element analysis indicate that CB 
      technology exhibits significantly lower maximum displacement, bone stress, and 
      wire stress compared to that with other technologies under different loads. 
      Additionally, in biomechanical experiments, the average force displacement in the 
      CB group was significantly smaller than that with other methods under a 500-N 
      force (P < 0.05). CONCLUSIONS: CB technology has the potential to overcome the 
      limitations of current techniques due to its superior biomechanical 
      characteristics. By incorporating early functional exercise and ensuring strong 
      internal fixation, patient prognosis could be enhanced. However, further clinical 
      trials are needed to fully evaluate the therapeutic effects of CB technology.
CI  - (c) 2023. BioMed Central Ltd., part of Springer Nature.
FAU - Fan, Wei
AU  - Fan W
AD  - Department of Orthopaedics, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
AD  - Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China.
FAU - Liu, Jinhui
AU  - Liu J
AD  - Department of Orthopaedics, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
AD  - Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China.
FAU - Tan, Xiaoqi
AU  - Tan X
AD  - Department of Dermatology, Affiliated Hospital of Southwest Medical University, 
      Luzhou, China.
FAU - Wei, Daiqing
AU  - Wei D
AD  - Department of Orthopaedics, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China.
AD  - Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China.
FAU - Yang, Yunkang
AU  - Yang Y
AD  - Department of Orthopaedics, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China. xnykdxff@163.com.
AD  - Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China. 
      xnykdxff@163.com.
FAU - Xiang, Feifan
AU  - Xiang F
AD  - Department of Orthopaedics, The Affiliated Hospital of Southwest Medical 
      University, Luzhou, China. xiangfeifan2022@163.com.
AD  - Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, China. 
      xiangfeifan2022@163.com.
LA  - eng
GR  - 2022NSFSC1534/the Natural Science Foundation of Sichuan Province/
GR  - 2022SAT12/Shang'antong Special Fund of Sichuan Medical Association/
PT  - Journal Article
DEP - 20231023
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
SB  - IM
MH  - Humans
MH  - Finite Element Analysis
MH  - Patella/diagnostic imaging/surgery
MH  - *Fractures, Bone/diagnostic imaging/surgery
MH  - Fracture Fixation, Internal/methods
MH  - Bone Wires
MH  - *Knee Injuries
MH  - Biomechanical Phenomena
PMC - PMC10594795
OTO - NOTNLM
OT  - Biomechanical experiments
OT  - Candy box technique
OT  - Finite element analysis
OT  - Fracture
OT  - Inferior Pole of the patella
OT  - Knee
COIS- The authors declare no competing interests.
EDAT- 2023/10/24 00:41
MHDA- 2023/10/27 06:42
PMCR- 2023/10/23
CRDT- 2023/10/23 23:47
PHST- 2023/08/01 00:00 [received]
PHST- 2023/10/07 00:00 [accepted]
PHST- 2023/10/27 06:42 [medline]
PHST- 2023/10/24 00:41 [pubmed]
PHST- 2023/10/23 23:47 [entrez]
PHST- 2023/10/23 00:00 [pmc-release]
AID - 10.1186/s12891-023-06946-1 [pii]
AID - 6946 [pii]
AID - 10.1186/s12891-023-06946-1 [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2023 Oct 23;24(1):835. doi: 10.1186/s12891-023-06946-1.