scholarly journals Management of patella fractures with different modalities

2019 ◽  
Vol 5 (3) ◽  
pp. 422
Author(s):  
Chokkarapu Ramu ◽  
Rajender K. ◽  
Anjaneyulu B. ◽  
Keertana B. ◽  
Shanmuga Raju P.
Keyword(s):  
Orthopaedic Surgery ◽  
The Body ◽  
Tension Band ◽  
Prospective Clinical Study ◽  
Sesamoid Bone ◽  
Medical Sciences ◽  
Patella Fractures ◽  
Cancellous Screws ◽  
K Wires ◽  
Patellar Fractures

<p class="abstract"><strong>Background:</strong> Patella fracture is quite a common injury for all ages of patients, constituting approximately 1% of all skeletal injuries. Patella is the largest sesamoid bone in the body. The aim of study was to assess the functional outcome of patella fractures treated with modified tension band wiring using K wires and cannulated cancellous screws with tension band construct.</p><p class="abstract"><strong>Methods:</strong> This study was a prospective clinical study to be conducted at the Department of Orthopaedic Surgery, Chalameda Anand Rao Institute of Medical Sciences, Karimnagar from October 2016 to November 2018. Total, 20 patients with transverse patellar fractures were studied and divided into 2 groups according to the surgical technique: 10 patients were in the MKTB group and 10 patients in the CSTB group.<strong></strong></p><p class="abstract"><strong>Results:</strong> Total 20 patella fractures were included in this study.<strong> </strong>The Bostman’s score of ROM, pain, atrophy of quadriceps femoris, and effusion were all higher in the CSTB group than in the MKTB group.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that compared with the MKTB technique, CSTB fixation is an effective surgical procedure for treatment of displaced transverse patellar fractures.</p>

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.

scholarly journals The modified anterior ellipsoidal cap titanium cable tension band for comminuted patellar fractures

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987401
Author(s):  
Fasheng Wang ◽  
Tianyi David Luo ◽  
Chunyong Chen ◽  
Yun Xie ◽  
Zhangxiong Lin ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Tension Band ◽  
High Rate ◽  
Wound Complications ◽  
Functional Rehabilitation ◽  
Postoperative Function ◽  
Patella Fractures ◽  
The Mean ◽  
Patellar Fractures

Purpose: The purpose of this study was to assess the outcomes in a series of patients, who underwent cerclage and figure-of-eight tension band wiring using a single titanium cable for comminuted patellar fractures. Methods: We describe a modified tension band technique using a single titanium cable to create an ellipsoidal cap structure that combines the circumferential and figure-of-eight wrapping in the fixation of closed Association for the Study of Internal Fixation/Orthopaedic Trauma Association 34C2 and 34C3 patellar fractures. We retrospectively reviewed 25 patients (16 males and 9 females, mean age 54 years) who underwent the described fixation technique between 2015 and 2017. Postoperative function was evaluated using the Böstman score. Results: At the mean follow-up of 25 months (range 17–39 months), the mean Böstman score was 27.3 ± 2.6 points (range 23–30). Eighteen patients (72%) had excellent results (score ≥28); seven patients (28%) had good results (score 20–27); and no patients had an unsatisfactory result (score < 20). All surgical incisions healed without major wound complications. Two patients reported minor complications (soft tissue irritation, cellulitis). No patients demonstrated loss of reduction or implant failure during the follow-up period. Conclusion: The modified anterior ellipsoidal cap tension band using a single titanium cable created an effective tension band structure in the treatment of comminuted patella fractures. It is a simple operative technique that produced a stable fixation construct, which allowed early functional rehabilitation and weight-bearing with a high rate of excellent outcomes at 2 years after surgery.

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.

scholarly journals Screws vs. Solid Wires - The Better Method for Transverse Patellar Fracture Fixation - A Prospective Randomised Study

2021 ◽  
Vol 8 (17) ◽  
pp. 1163-1168
Author(s):  
Nagakiran K.V. ◽  
Sameer Wooly ◽  
Prasad Soraganvi ◽  
Sudeep Madhukar Nambiar ◽  
Balakrishna Gadiyar H ◽  
...  
Keyword(s):  
Tension Band ◽  
Tension Band Wiring ◽  
Definitive Treatment ◽  
Reliable Technique ◽  
Randomised Study ◽  
Significant Difference ◽  
Extensor Apparatus ◽  
Cancellous Screws ◽  
Patellar Fractures ◽  
Prospective Randomised Study

BACKGROUND Patella is a sesamoid bone that plays an important role in the extensor apparatus of the knee joint. Fractures of the patella constitute about 1 % of all fractures. Definitive treatment of the patellar fractures depends on the type of fracture, displacement, joint congruity, and intactness of the extensor apparatus. There is significant controversy about the surgical options for displaced patellar fractures. Although conventionally tension band wiring using K-wires (TBW-K wire) is a common procedure, tension band wiring using cancellous screws (TBW-CCS) is gaining popularity. A study was undertaken to compare outcomes between the two procedures (TBW-CCS & TBW-K wire). METHODS A prospective randomised study was planned. Inclusion & exclusion criteria were laid down. Institutional ethical committee clearance was obtained. 68 consenting patients with transverse patellar fractures underwent surgery (TBW-CCS or TBWK wire) after randomisation. Demographic, clinical, and radiological assessment was done. Bostman score was used as an outcome measure. Statistical analysis was done. RESULTS 85.5 % of cancellous screw group patients had excellent outcome scores as against 41.2 % in the K wire group. The difference was statistically significant. 5.8 % of patients in the cancellous group complained of implant prominence as against 17.6 % in the K wire group which was statistically significant as well. Patients in TBW-CCS had a statistically significant difference in Bostman scores at 6 weeks, 3 months, and 6 months. CONCLUSIONS Tension band wiring with cannulated cancellous screws is a safe and reliable technique in the management of transverse patellar fractures with fewer chances of implant failure and soft tissue irritation. Based on our study, tension band wiring with cannulated cancellous screws is a better method to treat transverse fractures of the patella when compared to the modified tension band wiring technique using K-wire. KEYWORDS Patella, Transverse Fracture, Tension Band Wiring, Cancellous Screws

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 A precise navigation device for fixation of patella fractures with modified K-wire tension band: A comparative retrospective study

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 was designed by solidworks2012 software (USA), which could provide a precise guidance for obtaining a parallel K-wires. Besides, it could 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 were employed in this retrospective study. The patients were divided into P-MTBW group and C-MTBW group according to the surgical technique with or without the precise navigation device. We needed 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 at one year) 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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