Avulsion fractures of the tibial tuberosity in adolescent athletes treated by internal fixation and tension band wiring

Five cases with an avulsion fracture of the thumb metacarpophalangeal joint treated by a simple method of internal fixation are described. This method is designed as a form of modified tension band wiring using the combination of a single Kirschner wire and a pull-out wire, and is technically easy.

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Avulsion fractures of the tibial tuberosity in adolescents treated by tension band wiring

Orthopedie Traumatologie ◽

10.1007/bf01796527 ◽

1993 ◽

Vol 3 (3) ◽

pp. 247-250

Author(s):

P. Nikiforidis ◽

G. Ch. Babis ◽

J. Galouzis ◽

Th. Pantazopoulos

Keyword(s):

Tibial Tuberosity ◽

Tension Band ◽

Tension Band Wiring ◽

Avulsion Fractures

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Outcome of Inferior Patellar Pole Avulsion Fractures

Journal of Lumbini Medical College ◽

10.22502/jlmc.v4i2.97 ◽

2016 ◽

Vol 4 (2) ◽

pp. 84

Author(s):

Ruban Raj Joshi ◽

Rajeev Dwivedi ◽

Subin Byanjankar ◽

Rahul Shrestha

Keyword(s):

Internal Fixation ◽

Hospital Stay ◽

Open Reduction ◽

Tension Band ◽

Tension Band Wiring ◽

Patellar Ligament ◽

Suture Repair ◽

Avulsion Fractures ◽

Inferior Pole ◽

Tension Band Wire

Introduction: The optimal treatment for inferior pole patella avulsion fractures has still been a topic of debate. The options include (a) internal fixation of the pole fragment and (b) resection of the avulsed fragment and repair of the patellar ligament to the patella. We present the comparative outcomes for patients with displaced inferior pole patella treated by resection and transosseous Ethibond® Krackow suture repair of patellar ligament with open reduction and internal fixation with modified tension band wiring and circumferential wiring. Methods: During a three year period between August 2013 and September 2016, twenty consecutive patients with distal pole fractures of the patella were prospectively enrolled in this study. These patients were divided into two groups. Group-T patients were treated with open reduction and internal fixation with modified tension band wire and group-R patients by resection of the avulsed fragment and reattachment of the patellar ligament to the patella with #5 Ethibond®. Data entry and analysis was done by using SPSS version 20. Anatomical and functional outcome were compared. Results: Consecutive 20 patients were treated either with resection lower patellar pole (n=10) or with open reduction internal fixation with tension band wiring (n=10). Demographics were matched in two groups. Group-T required a longer hospital stay (U=13.5, p=0.005). Complications were seen more often in Goup-T compared to Group-R (p=0.005). Group-R had better scores (Bostman score U=6, p=0.001; SFMA U=7.5, p=0.001) and range of movement (p<0.05). Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had better outcome according to the Bostman and SFMA dysfunction score, shorter hospital stay, and less complications as compared to open reduction and internal fixation with tension band wire and circumferential wiring.

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Open reduction and internal fixation of avulsion fractures in the hand: The tension band wiring technique

Techniques in Orthopaedics ◽

10.1097/00013611-199106000-00004 ◽

1991 ◽

Vol 6 (2) ◽

pp. 10-18 ◽

Cited By ~ 2

Author(s):

Jesse B. Jupiter ◽

Howard A. Lipton

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Tension Band ◽

Tension Band Wiring ◽

Avulsion Fractures

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Results of tension band wiring in intra-articular collateral ligament avulsion fractures of the phalanx

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v6i2.19807 ◽

2018 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Rajeev Raj Manandhar ◽

Shishir Lakhey ◽

Umash Karki

Keyword(s):

Functional Outcome ◽

Soft Tissues ◽

Proximal Phalanx ◽

Ring Finger ◽

Ulnar Collateral Ligament ◽

Tension Band ◽

Tension Band Wiring ◽

Collateral Ligament ◽

Avulsion Fractures ◽

Radial Collateral Ligament

Background: Avulsion fractures of the base of proximal phalanx associated with ulnar or radial collateral ligament instability are relatively rare. The small size of the fragment and strong deforming pull of the attached soft tissues make the process of reduction and maintenance difficult.Objective: The purpose of this study was to assess the functional outcome of tension band wiring in intra-articular avulsion fractures of the base of the proximal phalanx.Methodology: A prospective study was performed on ten patients with intra-articular collateral ligament avulsion fractures of the proximal phalanx (Jupiter’s classification Type III). A tension band construct was performed using a dorsal approach. The functional outcome was assessed at six months with the quick Disability of Arm, Shoulder and Hand score.Results: The mean age of the patients was 25.8 years (Mean ± SD: 25.80). Six avulsion fractures were of the ulnar collateral ligament of the proximal phalanx of the index finger, one involved the radial collateral ligament of the ring finger and three, the radial collateral ligament of the little finger suggesting an abduction injury. All fractures had united at three months. Eight patients were graded as excellent and two as good. All patients were satisfied with the surgery and the functional outcome of the injured digit. There were no perioperative complications.Conclusion: The functional outcome of tension band wiring in intra-articular collateral ligament avulsion fractures of the base of the proximal phalanx was good to excellent.

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Modified Tension Band Wiring Fixation for Avulsion Fractures of the Calcaneus in Osteoporotic Bone: A Review of Three Patients

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2011.10.049 ◽

2012 ◽

Vol 51 (3) ◽

pp. 330-333 ◽

Cited By ~ 12

Author(s):

Issei Nagura ◽

Hiroyuki Fujioka ◽

Masahiro Kurosaka ◽

Hiroyuki Mori ◽

Makoto Mitani ◽

...

Keyword(s):

Tension Band ◽

Tension Band Wiring ◽

Osteoporotic Bone ◽

Avulsion Fractures

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Open Reduction and Internal Fixation of Patellar Fractures with Tension Band Wiring through Cannulated Screws

The Journal of Knee Surgery ◽

10.1055/s-0033-1364100 ◽

2014 ◽

Vol 27 (05) ◽

pp. 377-382 ◽

Cited By ~ 6

Author(s):

Manzoor Halwai ◽

Mudasir Malik

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Tension Band ◽

Tension Band Wiring ◽

Cannulated Screws ◽

Patellar Fractures

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Tibial tuberosity transposition-advancement for lateralization of the tibial tuberosity: An ex vivo canine study

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-13-12-0150 ◽

2014 ◽

Vol 27 (04) ◽

pp. 271-276 ◽

Cited By ~ 3

Author(s):

N. Bertollo ◽

W. Walsh ◽

K. Voss ◽

M. Newman

Keyword(s):

Computed Tomography ◽

Cyclic Loading ◽

Tibial Plateau ◽

Ex Vivo ◽

Peak Load ◽

Tibial Tuberosity ◽

Tension Band ◽

Tension Band Wiring ◽

Load To Failure ◽

Canine Study

SummaryObjectives: To evaluate the degree of lateralization achievable and strength of tibial tuberosity transposition and advancement (TTTA) relative to pin and tension band wiring (PTBW) for lateral tibial tuberosity transposition.Methods: Six pairs of cadaveric tibiae were used. Tibial tuberosity position was determined with computed tomography (CT); bones were then randomly assigned into TTTA and PTBW groups. The PTBW group had a tibial tuberosity osteotomy and fixation with pin and tension band wiring. The TTTA group had a tibial tuberosity advancement performed with lateralization of the tibial tuberosity by 50% of cage depth, using spacers on the cranial cage screw. Postoperative CT images showed lateralization and craniocaudal deviation. Single axial distractive loading was applied to the patella at 90° to the tibial plateau, and peak load, energy, and stiffness were calculated.Results: There were significant differences in lateralization (PTBW: 67.92 ± 5.1 %; TTTA: 88.51 ± 5.5 %) (p = 0.0173) and craniocaudal deviation (PTBW: –8.30 ± 1.4 %; TTTA: 6.83 ± 0.6) (p = 0.0001). There were no significant differences in peak load to failure (N) (PTBW: 1448 ± 121; TTTA: 1597 ± 43) (p = 0.4541), energy to failure (N/mm) (PTBW: 15013 ± 2719; TTTA: 17314 ± 887) (p = 0.646), or stiffness (N/mm)(PTBW: 102.8 ± 4.7; TTTA: 92.9 ± 4.8) (p = 0.2716).Clinical significance: The TTTA was more effective at lateralization of the tibial tuberosity, and of comparable strength to PTBW. Greater support of the osteotomized fragment with TTTA may resist cyclic loading, and requires evaluation.

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