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

2012 ◽  
Vol 21 (2) ◽  
pp. 311-317 ◽  
Author(s):  
Simon Thelen ◽  
Johannes Schneppendahl ◽  
Ralf Baumgärtner ◽  
Christian Eichler ◽  
Jürgen Koebke ◽  
...  
Keyword(s):  
Tension Band ◽  
Tension Band Wiring ◽  
Cannulated Screws ◽  
Fixed Angle ◽  
Patella Fractures ◽  
K Wires

scholarly journals Comparative study of Modified Tension Band Wiring versus Tension Band Through Parallel CannulatedCancellous Screws in Patella Fractures

2020 ◽  
Vol 4 (3) ◽  
pp. 777-781
Author(s):  
Praphulla Shrestha ◽  
Pralhad Kumar Chalise ◽  
Sujan Raj Paudel
Keyword(s):  
Soft Tissue ◽  
Complication Rate ◽  
College Teaching ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Medical College ◽  
Patella Fractures ◽  
Special Surgery ◽  
K Wires ◽  
Patellar Fractures

Introduction: Open reduction and internal fixation is indicated in patients with displaced patella fracturesand loss of the extensor apparatus.Transverse fractures of the patella are commonly treated with modified tension band wire (MTBW). Loosening of the wires along with the implant construct and soft tissue irritation by the wires had already been reported. The newer technique, tension band wiring through cannulated cancellousscrews(TBWCCS) is soft tissue friendly and gives better stability.  Objective: The objective of this study is to compare the outcome of treatment of patella fractures by modified tension band wiring with k wires and tension band wiring through parallel cannulated cancellous screws in terms of union rate, functional outcome and complication rate. Methodology: We performed acomparative study between the two procedures from September 2017 to January 2019 at Nepal Medical College Teaching Hospital. Total of 40 patients, 20 in each groupware enrolled in the study.Allthe patients were followed at regular intervals. Time taken for radiographic union was recorded. Variables of Modified Hospital for Special Surgery Knee Score (MHSSKS) were recorded and graded till the last follow-up at 24 weeks. Complications of each procedure were recorded.The data was analyzed using SPSS version 16. Results: All fractures united at 12.20±3.03 weeks in MTBWgroup and 11.20±2.78 weeks in TBWCCS group. Complication rate was significantly higher in MTBW group. In TBWCCS group, 90% patients had good to excellent MHSSKS score whilein MTBW group, 75% had good to excellent results at 24 weeks. Pain during walking was significantly better in TBWCCS group.  Conclusion: On the basis of our study, tension band wiring through cannulated cancellousscrews is an effective method of treatment of patellar fractures.

Fixation of Closed Transverse Patella Fracture with Cannulated Cancellous Screws and Anterior Tension Band Wiring- A Prospective Study

2020 ◽  
Vol 11 (4) ◽  
pp. 7985-7989
Author(s):  
Senthil Loganathan ◽  
Raghavendran B ◽  
Thiyagarajan U ◽  
Pradeep J
Keyword(s):  
Prospective Study ◽  
Steel Wire ◽  
Knee Function ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Patella Fracture ◽  
Cancellous Screw ◽  
Patella Fractures ◽  
Cancellous Screws ◽  
A Prospective Study

Patella fractures accounts for 1% of all skeletal injuries.  Patella fractures usually need to be treated with accurate reduction and fixation to obtain optimal knee function. Improper reduction of the articular fragments leads to complications like arthritis and quadriceps dysfunction. Tension band wiring and pasting are commonly performed fixation methods. Tension band wiring with K-wires is associated with wire prominence and soft tissue irritation. Cannulated cancellous screw fixation of the fracture and tension band wiring through the cannulated screws avoid the complication of wire migration and breakage.   In our study, we fixed these fractures with cannulated cancellous screws and tension band. This is a prospective study done in SRMC from 2012-2017. A total of 17 Patients with transverse patella fracture are taken into a study, 4mm cannulated cancellous screws with 18 mm stainless steel wire is used for anterior tension band wiring. Extensor retinaculum closure is done for all these patients. All patients had excellent knee function, according to KSS. There was no case of implant prominence or soft issue irritation in any of these patients. One patient had extensor lag. Cannulated cancellous screw with anterior tension band wiring is a reliable, effective and reproducible technique in treating transverse patella fractures.

Miniplate Augmented Tension-Band Wiring for Comminuted Patella Fractures

2019 ◽  
Vol 33 (4) ◽  
pp. e143-e150 ◽  
Author(s):  
Jae-Woo Cho ◽  
William T. Kent ◽  
Won-Tae Cho ◽  
Jin-Kak Kim ◽  
Ki-Ho Moon ◽  
...  
Keyword(s):  
Tension Band ◽  
Tension Band Wiring ◽  
Patella Fractures

scholarly journals Comparison of total patellectomy and osteosynthesis with tension band wiring in patients with highly comminuted patella fractures: a 10–20-year follow-up study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiangtian Deng ◽  
Lian Zhu ◽  
Hongzhi Hu ◽  
Jian Zhu ◽  
Weijian Liu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Peak Torque ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Patient Demographics ◽  
Patella Fractures ◽  
Sf 36 ◽  
Kujala Score ◽  
Injured Knee

Abstract Background The purpose of this study was to evaluate and compare the long-term clinical outcomes between the total patellectomy and osteosynthesis with tension band wiring in patients with highly comminuted patella fractures. Methods Between January 1987 and December 2003, this retrospective study included a total of 35 patients (mean age, 51.4±16.8 years) with a minimum of 10 years follow-up period, comprising 29 males and 6 females, who were divided into the total patellectomy group (17 patients) or the open reduction and internal fixation (ORIF) group (18 patients) in the Third Affiliated Hospital of Hebei Medical University. We retrospectively collected patient demographics and data on the type of trauma, fracture type, and postoperative complications. Clinical outcomes including knee range of motion (ROM), 36-Item Short-Form Health Survey (SF-36) score [including physical component score (PCS) and mental component score (MCS)], Knee Injury and Osteoarthritis Outcome Score (KOOS), and Kujala score were evaluated and compared between the two groups. Biodex System dynamometer was used to quantitatively evaluate quadriceps femoris muscle power following measurement of peak torque. Results The mean follow-up periods of the total patellectomy group and the ORIF group were 17.2±5.6 and 16.8±4.9 years, respectively. There were no significant differences between the two groups of patient demographics in terms of the number of patients, age, sex, injury side, time to surgery, type of trauma, and fracture classification (p>0.05). Total patellectomy was comparable to osteosynthesis with tension band wiring in terms of ROM [injured knee: 120.4±3.1° vs 118.6±3.3°; uninjured knee: 126.5±2.8° vs 127.3±1.7°; both p>0.05], peak torque [Injured knee: 96.2±2.3 vs 97.3±2.6, N· m; Uninjured knee: 107.6±2.1 vs 106.3±1.8, N· m; both p>0.05], SF-36 score [PCS: 64.1±18.0 vs 61.5±17.9; MCS: 55.1±13.8 vs 54.3±12.4; both p>0.05], KOOS score [76.3±12.1 vs 73.4±11.7; p>0.05], and Kujala score [67.6±11.8 vs 70.8±11.9; p>0.05] at the final follow-up, while total patellectomy had significantly shorter operation time than ORIF group (47.5±12.1 vs 68.8±22.3, min, p<0.05). In the total patellectomy group, complications occurred in 6 of 17 cases (35.3%), and all occurred with calcification. In the ORIF group, complications occurred in 12 of 18 cases (66.7%), including 2 cases of infection (11.1%), 1 case of non-union (5.6%), 2 cases of implant failure (11.1%), 2 cases of soft tissue irritation (11.1%), and 5 cases of patellofemoral arthritis (27.8%). Conclusions Total patellectomy technique was a safe and reliable alternative treatment for treating patients with highly comminuted patella fractures when anatomically reduction and rigid fixation were difficult, although it caused relatively higher rates of calcification.

scholarly journals Comparative study of management of olecranon fractures using tension band wiring technique with cancellous screw and K wires

2016 ◽  
Vol 2 (3) ◽  
pp. 109
Author(s):  
Krishnaprasad H. S. ◽  
Shivanna Shivanna
Keyword(s):  
Comparative Study ◽  
Clinical Results ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Cancellous Screw ◽  
Medical College ◽  
Prospective Comparative Study ◽  
Group 5 ◽  
K Wires ◽  
Olecranon Fractures

<p class="abstract"><strong>Background:</strong> Olecranon fractures are commonly seen injuries in the emergency room. The surgical management of displaced fractures is open reduction and internal fixation with k-wires and figure of eight tension band wiring. It can also be fixed with intramedullary cancellous screw with tension band wiring. The present study is to compare the results of both the surgical procedures and to assess the merits and demerits.</p><p class="abstract"><strong>Methods:</strong> This prospective comparative study was carried out from August 2012 to November 2013 in Bapuji Hospital and Chigateri General Hospital attached to J.J.M Medical College, Davangere, India, where among 20 olecranon fractures, ten were treated with Tension band wiring with Kirshner wire and another ten treated with intramedullary cacellous screw with tension band wiring and the results were evaluated and compared.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, most of the cases were type II B fractures according to Colton’s classification. According to Mayo elbow performance score, Excellent  results found  in 8  patients (80%), good in1patient (10%)  and fair in 1 patient (10%) in cancellous screw group and in K wire group, 5 patient (50%) had excellent, 3 patient (30%) had good  and 2 patients (20%) had fair results. No poor result was seen in both groups.</p><p><strong>Conclusions:</strong> From this study it is concluded that using cancellous screw with tension band wiring for displaced transverse and oblique olecranon fractures gives better clinical results when compared to tension band wiring with K-wire fixation avoiding cost, work time loss and possible complications from hard ware removal.</p>

scholarly journals A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application

2020 ◽  
Author(s):  
Fuming Wang ◽  
Haolan Xiong ◽  
Xiaotao Long ◽  
Yang Li ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Procedure ◽  
Evaluation Criteria ◽  
Operation Time ◽  
Tension Band ◽  
Standard Position ◽  
Patella Fractures ◽  
Intraoperative Fluoroscopy ◽  
Significant Difference ◽  
K Wires

Abstract Background Traditionally, the technique of modified tension band wires (MTBW) has been the most commonly used surgical procedure. The purpose of this study is to design a precise navigation device that can obtain a standard position of K-wires for (MTBW), and to compare the precise MTBW (P-MTBW) by a navigation device with the conventional MTBW (C-MTBW) by hands in a retrospective study.Methods The device is designed by solidworks2012 software (USA), which can provide a precise guidance for obtaining a parallel K-wires. In addition, it can set the distance between two k-wires and the level of k-wires below patellar anterior surface. From June 2014 to August 2018, a total of 112 patients are employed in this retrospective study. The patients are divided into P-MTBW group and C-MTBW group according to the surgical technique with or without the precise navigation device. We need to record and analyze the operation time and the number of fluoroscopy, postoperative internal fixation imaging, knee function and complications.Results There were 54 patients in P-MTBW group and 58 patients in C-MTBW group. There were statistically significant differences(P＜0.001) in the operation time between P-MTBW group (39.5±4.7; range, 32–49 minutes) and C-MTBW group (53.7±6.8; range, 42–71 minutes). The number of intraoperative fluoroscopy was significantly less (P＜0.001) in P-MTBW group(4.2±1.4) versus that of C-MTBW group (8.3±2.7). According to Iowa knee score, there was no significant difference (P=0.268) in function between the two groups. According to our own evaluation criteria for MTBW, anyone in the P-MTBW group was excellent and 26 patients were excellent, 20 patients were good and 2 patients were fair in the C-MTBW group.Conclusion The navigation device can reduce operation time and intraoperative fluoroscopy frequency. P-MTBW fixation is an accurate and effective surgical procedure for patella fractures.

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