scholarly journals Clinico-radiological and functional outcome of surgical management of displaced transverse fracture of patella in adults managed by tension band wiring in a tertiary care hospital in North India: a prospective study

2021 ◽  
Vol 10 (1) ◽  
pp. 122
Author(s):  
Pankaj Spolia ◽  
Ashish Nehru ◽  
Abdul Ghani ◽  
Sakib Arfee
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Surgical Management ◽  
Quadriceps Muscle ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Transverse Fracture ◽  
Main Function ◽  
Care Hospital ◽  
Transverse Fractures

Background: Patella is the largest sesamoid bone in the quadriceps tendon in the body. The main function of patella is to improve the efficiency of quadriceps muscle by improving the mechanical leverage of the quadriceps muscle. There are various methods used for fixation of these fractures. Tension band wiring (TBW) works by converting tensile forces into compressive forces when movements occur at the knee joint. The aim of our study was to evaluate the clinico-radiological and functional outcome of surgical management of displaced transverse fracture of patella in adults managed by TBW.Methods: This was the prospective study of 22 patients aged 20 to 60 years (mean age 41.4 years) with displaced transverse fractures of patella managed by TBW.Results: The final outcome was observed at 6 months follow up. The results were comparable with the existing literature. Radiological union was achieved within 10 to 16.2 weeks, with an average of 12.4 weeks. Out of 22, (n=16, 72.7%) had excellent outcome, (n=5, 22.7%) had good functional outcome, (n=1, 4.5%) had fair outcome. Complications were observed in 6 (27.3%) patients.Conclusions: It is concluded that the surgical treatment with TBW is the best treatment in the management of displaced transverse fractures of patella.

Evaluation of Functional Outcome of Patients with Transverse Fracture of Patella Treated with Tension Band Wiring - A Prospective Study Conducted at Trichur, Kerala

2021 ◽  
Vol 8 (30) ◽  
pp. 2757-2762
Author(s):  
Prakash Ponnan ◽  
Manoj Murungodiyil Kunjappan
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Treatment Option ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Extensor Mechanism ◽  
Transverse Fracture ◽  
Early Weight Bearing ◽  
Fracture Patella ◽  
Study Population

BACKGROUND Patella is the largest sesamoid bone in the human body, which plays important role in biomechanics of the knee. It is one of the few bones without periosteal surrounding. Fracture of patella constitute almost 1 % of all skeletal injuries with high prevalence in age group of 20 - 50 years. Fracture of patella may be due to direct/indirect force. Direct force often results in displaced or comminuted fractures. Fracture caused by indirect mechanisms result from a violent contraction of quadriceps muscle with knee flexion. Most of the patella fractures are combination of direct and indirect forces. Most significant effects of fracture patella are loss of continuity of the extensor mechanism of the knee and potential incongruity of the patellofemoral articulation. Treatment option includes reconstruction of entire patella or partial patellectomy and tendon repair or total patellectomy with extensor mechanism repair. Advancement in surgical techniques treatment option being shifted from patellectomy to reconstruction, preservation, and restoration of extensor mechanism. The purpose of this study was to evaluate the functional outcome of transverse fracture of patella treated with tension band wiring. METHODS This prospective study was done among 35 patients, who sustained transverse patellar fractures and were admitted in Department of Orthopaedics, Government Medical College, Thrissur from 01 October 2019 to 01 October 2020. Functional and clinical outcome was assessed at 2 weeks, 4 weeks, 3 months, and 6 months using Goodfellow’s scoring system. RESULTS The mean age was found to be 43 years, males were predominant. In 62.86 % of study population, right side was involved. In 63 % of study population, fracture occurred due to road traffic accidents (RTA). Average union was achieved in 11 - 13 weeks. Functional outcome was excellent to good in 85.71 % of study population. CONCLUSIONS Transverse fracture of patella can be treated with modified tension band wiring without much complications and early weight bearing is possible with good functional outcome. KEYWORDS Transverse Fracture Patella, Prospective Study, Tension Band Wiring, Good Fellows Score

scholarly journals Functional outcome of surgical management in cases of fracture patella in a tertiary care hospital in Salem

2021 ◽  
Vol 7 (3) ◽  
pp. 507
Author(s):  
Nikhilesh P. S. ◽  
Hari Sivanandan ◽  
Anandanarayan M. ◽  
A. E. Manoharan
Keyword(s):  
Functional Outcome ◽  
Tertiary Care ◽  
Lateral View ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Definitive Treatment ◽  
Care Hospital ◽  
Common Procedure ◽  
Fracture Patella ◽  
Underlying Mechanisms

<p><strong>Background: </strong>Fractures of the patella are serious injuries with a broad range of subtypes. These injuries account for about 1% of all skeletal injuries and are most prevalent within the age group of 20-50 years. The underlying mechanisms of open fractures are mostly high-velocity accidents. To assess the functional outcome of various surgical procedures done for fracture patella.</p><p><strong>Methods: </strong>A longitudinal study was conducted from the department of orthopedics, Vinayaka missions Kirupananda Variyar medical college and hospital, Salem for one year in August 2019 and July 2020. All the adult patients admitted with the diagnosis of patellar fracture were included in the study. A complete local examination was conducted and an X-ray of AP and the lateral view was taken for all the patients.</p><p><strong>Results: </strong>Transverse patella fracture is being the most common fracture and for that modified tension band wiring (TBW) was the most common procedure performed and for comminuted fracture partial patellectomy was the most common procedure and for 1 patient total patellectomy was performed.</p><p><strong>Conclusions:</strong><strong> </strong>The study shows that the treatment of patella fractures with modified tension band wiring is a definitive treatment with minimal complications and excellent functional outcomes.</p>

scholarly journals Clinico-radiological and functional outcome of Mayo type IIA olecranon fractures managed with tension band wiring in a tertiary care centre in North India

2021 ◽  
Author(s):  
Pankaj Spolia ◽  
Abdul Ghani ◽  
Sakib Arfee
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Road Traffic ◽  
Tertiary Care ◽  
Tension Band ◽  
Tension Band Wiring ◽  
North India ◽  
Tertiary Care Centre ◽  
Transverse Fractures ◽  
Olecranon Fractures

<p class="abstract"><strong>Background: </strong>Tension band wiring is the most common operative technique for the internal fixation of olecranon fractures. Stable internal fixation with figure of eight tension band wiring used for simple transverse fractures allows early range of motion, minimize stiffness and gives good results. The aim of this study is to evaluate the functional outcome of simple transverse fractures managed by tension band wiring.</p><p class="abstract"><strong>Methods:</strong> This was an observational prospective study of 24 patients with Mayo type IIA fractures aged between 18 to 65 years, with mean age of 42.5 years treated by tension band wiring. Functional outcome was assessed with Mayo Elbow Performance Score (MEPS) and Visual Analogue Scale (VAS) subjective pain score.</p><p class="abstract"><strong>Results: </strong>Our study was conducted on 24 patients with Mayo type IIA, out of which 16 were males and 8 were females. Most common mode of injury was fall from standing height (75%), followed by road traffic accident (16.7%) and assault (8.3%). The age range was between 18 to 65 years, with mean age of 42.5 years.</p><p class="abstract"><strong>Conclusions:</strong> Tension band wiring is an effective method for the treatment of transverse, non-comminuted and unstable fractures of the olecranon which provides stable fixation, early rehabilitation and gives excellent results when done in expert hands.</p>

scholarly journals A comparative study of tension band wiring and encirclage in treating transverse fractures of patella

2017 ◽  
Vol 4 (5) ◽  
pp. 1558
Author(s):  
Subrat Mohapatra ◽  
Pulin Bihari Das ◽  
R. V. Krishnakumar ◽  
Sibanarayan Rath ◽  
Rabindra N. Padhy
Keyword(s):  
Full Range ◽  
Early Mobilization ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Transverse Fracture ◽  
Radiological Outcome ◽  
Operative Complications ◽  
Fracture Patella ◽  
Group A ◽  
Transverse Fractures

Background: The functional and radiological outcome of the union of transverse fractures of patella treated by tension band wiring (TBW) and encirclage wiring were compared according to WEST’s criteria.Methods: During three years, 44 patients with displaced transverse fracture patella were treated randomly either by TBW or encirclage with twenty-two patients in each group. Two patients in each group were lost to follow-up.Results: Results were compared based on the period of union, post-operative complications, early mobilization and recovery to pre-injury level. Fractures united at an average of 13.6 weeks with 8-12 and 10-14 weeks in TBW and the encirclage group, respectively. Results were excellent in 65%, good in 25% and poor in 10% cases in TBW group, as compared to the encirclage group with excellent in 50%, good in 30% and poor in 20% cases. In TBW group, 75% cases had a full range of motion (ROM), 15% had >120° of flexion and 10% had flexion between 90° and 120°, as compared to 50% full ROM, 30% >120° of flexion and 20% between 90° and120° flexion in the encirclage group.  A case of migration of pin and another case of limitation of flexion by 25° were noticed.Conclusions: Patients treated with TBW had better results than the encirclage in the management of transverse fractures of the patella.

scholarly journals ORIF with Tension band wiring in transverse fractures of the patella-A prospective study

2021 ◽  
Vol 12 (1) ◽  
pp. 169-174
Author(s):  
Yeshwanth subash ◽  
Damodharan ◽  
Vishnu S
Keyword(s):  
Functional Outcome ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Effective Treatment Option ◽  
Surgical Time ◽  
The Mean ◽  
The Right ◽  
A Prospective Study ◽  
Patellar Fractures ◽  
Transverse Fractures

Fractures of the patella account for 1% of all fractures and can be managed by both conservative and surgical means. By this study, we aimed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of transverse patellar fractures with TBW (Tension band wiring). Thirty patients with patellar fractures who presented between June 2011 to June 2014 were managed surgically and were followed up for three years. Functional analysis was performed using the Lysholm scoring system. The patients in our study had a mean age of 42.86 years ranging from 19 to 71 years. There were 18 males and 12 females in our study with the right knee being more commonly affected. The mean surgical time was 57.66 minutes ranging from 45 to 70 minutes, and the average blood loss was 180.5 ml ranging from 160 to 210 ml We were able to achieve a 100% union rate in our series with the average time to fracture union being 11.83 weeks. The mean Lysholm score was 87.80±11.20. All patients were satisfied with the functional outcome and were able to return to activities of work and daily living to the best possible extent. ORIF with TBW is an effective treatment option in the management of transverse fractures of the patella, and it gives good radiological and functional outcomes to the patients.

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

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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