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 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.

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

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fuming Wang ◽  
Haolan Xiong ◽  
Xiaotao Long ◽  
Yang Li ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Procedure ◽  
Evaluation Criteria ◽  
Operation Time ◽  
Knee Score ◽  
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 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 min) and C-MTBW group (53.7 ± 6.8; range, 42–71 min). 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 1 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.

scholarly journals Open reduction and internal fixation using multiple nonabsorbable suture materials in acute patella fracture: comparison of clinical and radiological outcome with tension band wiring

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Kwang Won Lee ◽  
Sang Beom Ma ◽  
Dae Suk Yang ◽  
Seung Hak Oh ◽  
Seong Ho Park
Keyword(s):  
Operation Time ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Bone Union ◽  
Suture Materials ◽  
Nonabsorbable Suture ◽  
Patella Fractures ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background For treating displaced patella fractures, tension band wiring is the most widely used technique. However, implant removal surgery is often necessary to alleviate discomfort caused by fixation materials. On the contrary, fixation using nonabsorbable suture materials is anticipated to result in comparable outcomes without need for further implant removal surgery. However, there is a lack of clinical studies comparing the two fixation techniques (wire and nonabsorbable suture materials) for acute patella fractures. Methods From 2014 to 2018, we retrospectively reviewed 60 patients who underwent open reduction with internal fixation for acute patella fracture. Thirty patients (group 1) who received surgery using tension band wiring and 30 patients (group 2) who received surgery using nonabsorbable suture materials were enrolled. The average follow-up period was more than 1 year after operation. Operation time, postoperative bone union time, range of motion (ROM) of the knee joint, postoperative clinical results, and complications were compared between the two groups. Result Operation time, clinical bone union, and radiologic bone union were not statistically different between groups 1 and 2. At 3 months postoperatively, flexion was 120.3 ± 9.4° in group 1 and 110.5 ± 7.7° in group 2, showing statistically significant difference (p = 0.037). At 6 and 12 months postoperatively, the ROM was similar in both groups. Hospital for special surgery score at 3 months postoperatively was 78.4 ± 8.2 in group 1 and 83.7 ± 8.7 in group 2, showing statistically significant differences (p = 0.032). However, at 6 and 12 months postoperatively, there were no statistical differences. Lysholm score at 3 months postoperatively was 73.5 ± 8.1 in group 1 and 80.4 ± 8.2 in group 2, showing statistically significant difference (p = 0.016), but at 6 and 12 months postoperatively, there were no statistical differences. Conclusion Fixation using multiple nonabsorbable suture materials can be an alternative surgical method in managing patella fractures, along with tension band wiring.

scholarly journals Modified Nuss operation using introducer-bar complex for pectus excavatum in adults: a retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lei Wang ◽  
Juan Liu ◽  
Yao Li ◽  
Tienan Feng ◽  
Beibei Cao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Pectus Excavatum ◽  
Operation Time ◽  
Nuss Procedure ◽  
Plate Removal ◽  
Traditional Procedure ◽  
Group Outcomes ◽  
Significant Difference ◽  
Clinical Benefits

Abstract Background Shortcoming of traditional Nuss operation on adults is gradually found in the clinical practice. A new kind of introducer-bar complex was introduced. However, there is limited evidence regarding its safety and efficacy. Therefore, a single center, retrospective study was conducted to address this issue. Methods Patients with pectus excavatum who underwent surgery between January 2015 and June 2017 were consecutively enrolled in this study. In all, 52 patients underwent the modified procedure using the introducer-bar complex (new procedure group), whereas 48 underwent the traditional anti-Nuss procedure (traditional procedure group). Outcomes analysis of balanced baseline was performed to compare the intraoperative and postoperative short-term outcomes. Results All patients in the new procedure group had shorter operation duration (51.54 ± 20.32 vs. 79.45 ± 13.88 min, p = 0.017), postoperative hospitalizations (4.77 ± 1.62 vs. 6.86 ± 2.18 days, p = 0.028), plate removal surgery durations (39.30 ± 8.97 vs. 60.30 ± 10.49 min, p < 0.001), and less blood loss during operation (6.25 ± 4.88 vs. 10.90 ± 5.75 ml, p = 0.003) than patients in the traditional procedure group. There was no significant difference in the length of incision, postoperative Haller index, cost, number of steel bars, postoperative surgical outcome and incidence of complications between the two groups. Conclusion Through the main clinical outcome were similar, our results shown that modified procedure may have the shorter operation time, postoperative hospital stay, and operation time for plate removal and less blood loss, which may bring potential clinical benefits to patients.

scholarly journals Intraoperative mobilisation of knee and its effect on the final functional outcome in patella fractures: a clinical study

2018 ◽  
Vol 4 (4) ◽  
pp. 642
Author(s):  
Deepak Aher ◽  
Ajay Dandotiya ◽  
Dharmendra Raghuvanshi ◽  
Abhishek Pathak
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Rating Scale ◽  
Road Traffic ◽  
Weight Bearing ◽  
Operation Time ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Early Weight Bearing ◽  
Patella Fractures

<p class="abstract"><strong>Background:</strong> Treatment of patellar fractures depends on its type, integrity of extensor mechanism and fragments size. Operative measures are tension band wiring and partial or total patellectomy. Early weight bearing and then gradual mobilization and finally quadriceps strengthening remains the crux of physiotherapy. Aim of this study was to see for the effect of intraoperative mobilisation of knee on functional outcome of tension band wiring in patella fractures.</p><p class="abstract"><strong>Methods:</strong> 30 patients were included in this study from January 2016 to February 2018. Tension band wiring was performed in all the patients. Intraoperative mobilisation of knee as allowed was done when patient was under effect of anesthesia. Final functional outcome was assessed as per the modified knee-rating scale of the Hospital for Special Surgery and also range of motion noted. Patients were evaluated at 1 month, 2 month, 6 month and 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Patients aged from 25-65 years with mean age of 40 years. 26 patients were male and 4 female. In 20 cases, Right knee was involved. All had trauma due to road traffic accident. Mean operation time was 1 hour. At the end of 1 year follow up only 2 patients had range of motion &lt;90, 4 patients had range of motion 90-120 degrees and 24 patients had range of motion &gt;120 degrees. After 1 year, functional outcome was, excellent in 24, good in 4, fair in 1 and poor in 1.</p><p class="abstract"><strong>Conclusions:</strong> Intraoperative mobilisation of knee after a stable fixation with tension band wiring of patella can prove to a very effective method for increasing postoperative range of motion and improving functional outcome.</p>

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 Assessment of incidence of post-operative wound infection in women undergoing caesarean section: a retrospective study

2018 ◽  
Vol 7 (6) ◽  
pp. 2328
Author(s):  
Radha Sangavi ◽  
Rajkumari K. S.
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Caesarean Section ◽  
Wound Infection ◽  
Demographic Data ◽  
Operation Time ◽  
Healthcare Systems ◽  
Prolonged Labour ◽  
Significant Difference ◽  
Duration Of Surgery

Background: The surgical site infection is the second most common infectious complication occurring after caesarean section. Infections occurring after caesarean section represent a considerable burden to the healthcare systems and preventing these complications is a priority of healthcare systems especially in developing countries. The aim of this study was to determine the incidence of SSI in patients undergoing a LSCS at a RIMS teaching hospital, Raichur, and to identify risk factors, common bacterial pathogens and antibiotic sensitivity.Methods: The present retrospective study was conducted in RIMS Institute, during a period of 3 years i.e. from 2013-2016. In this study a total of 50 cases were collected from MRD department. They were divided into two groups- cases and controls, each having 50 subjects each. Wound infection was defined as inflammation or sepsis with or without positive bacterial cultures. With SSI, there may be fever, redness, swelling and/or pain in the area around the incision site. Complete information regarding demographic data, the type and indication for caesarean section, duration of labour, duration of surgery and rupture of membrane were recorded. Wound infections occuring after 30 days of LSCS & other gynaecological surgeries were excluded. All the results were analyzed by SPSS software 16.0. Chi-square test and student t test were used for the assessment of level of significance. Probability value of less than 0.05 was considered significant.Results: A total of 100 subjects were included in the present study, out of which, 50 were cases and the remaining 50 were controls. The mean age of the subjects was 37.45 years. There were 7 cases and 13 controls who were aged between 20-24 years. There was no significant difference amongst cases and controls regarding age. There was a significant difference in the haemoglobin levels amongst cases and controls. The third criterion that was assessed was duration of labour. Majority of the cases had prolonged labour whereas in majority of the controls, the duration of labour of labour was less than 6 hours. There was a significant difference in duration of labour amongst cases and controls (p<0.05). Elective c section was done in 2 cases and 6 controls. C section was performed in an emergency in 48 cases and 44 controls. There was a significant difference in the operation time between cases and controls (p<0.05). E.coli infection occurred in 15 cases in the present study followed by Actinobacter species which occurred in 13 cases. Absence of growth was seen in 5 cases.Conclusions: The risk factors associated with SSI in our study were, haemoglobin levels, prolonged labour, duration of operation. The most common organisms isolated were E. coli and Actinobacter species.

scholarly journals Comparison of clinical and radiological results of fixation methods with retrograde intramedullary Kirschner wire and plate-screw in extra-articular metacarpal fractures

2021 ◽  
Vol 32 (2) ◽  
pp. 397-405
Author(s):  
Mehmet Baydar ◽  
Abdurrahman Aydın ◽  
Ayşe Şencan ◽  
Osman Orman ◽  
Serkan Aykut ◽  
...  
Keyword(s):  
Grip Strength ◽  
Kirschner Wire ◽  
Operation Time ◽  
Wound Complications ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Wire Fixation ◽  
K Wires ◽  
Surgery Duration

Objectives: In this study, we aimed to compare clinical and radiographic outcomes of retrograde intramedullary Kirschner-wire (K-wire) fixation with those of plate-screw (PS) fixation. Patients and methods: A total of 98 metacarpal shaft fractures in 75 patients (65 males, 10 females; mean age: 31.2±10.9 years; range, 16 to 65 years) were included between January 2011 and December 2017. The total joint active range of motion (AROM) and grip strength of the healthy and broken hands were evaluated. The Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were recorded. We compared surgery duration, number of fluoroscopy images, and cost-effectiveness for each technique. Results: The overall mean follow-up was 21.9 (range, 12 to 56) months. At the last follow-up, total joint AROM (p=0.072), VAS score (p=0.298), QuickDASH score (p=0.132), and hand grip strength (p=0.947) were similar between the groups. Radiological union occurred in the PS and K-wire groups in a mean of 5.84 (range, 3 to 8) and 4.46 (range, 3 to 20) weeks, respectively (p=0.173). A significant difference was found in surgery duration (p=0.021) and number of fluoroscopy images (p<0.05) between the PS and K-wire groups. Two wound complications were observed in the PS group and one with K-wires. Conclusion: Retrograde intramedullary K-wire fixation has certain advantages such as being less invasive and more accessible with shorter operation time, compared to PS fixation. Similar radiological and clinical scores can be obtained in patients undergoing retrograde intramedullary K-wire fixation or PS fixation.

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.

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