scholarly journals Surgical management of transverse fractures of patella by cannulated screws combined with tension band wiring: Prospective study

2020 ◽  
Vol 6 (3) ◽  
pp. 769-772
Author(s):  
Himanshu Agrahari ◽  
Chethan MH ◽  
Akshay Tegginamath ◽  
Sidharath Mohindru ◽  
Srinivas R
Keyword(s):  
Prospective Study ◽  
Surgical Management ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Cannulated Screws ◽  
Transverse Fractures

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.

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 Management of displaced transverse fractures of the patella using tension band wiring with or without circumferential cerclage wiring: A comparative study

2019 ◽  
Vol 7 (5) ◽  
pp. 1752
Author(s):  
Zubair A. Lone ◽  
John Mohd ◽  
John Mohd ◽  
Imtiyaz A. Beigh ◽  
Imtiyaz A. Beigh ◽  
...  
Keyword(s):  
Tension Band ◽  
Tension Band Wiring ◽  
P Value ◽  
Fixation Failure ◽  
Non Union ◽  
Recommended Treatment ◽  
Cerclage Wiring ◽  
Group 2 ◽  
Transverse Fractures ◽  
Group 1

Background: Transverse fractures of body of the patella are by far the most common fractures of this bone. Surgical fixation is the recommended treatment in displaced fractures with extensor lag. Although, tension band wiring (TBW) technique is the gold standard for these fractures, few surgeons recommend augmentation with circumferential cerclage wiring to improve the strength of the fixation. We compared the results of the internal fixation of displaced transverse fractures of the patella using TBW and circumferential cerclage wiring with those treated with TBW alone. Methods: We treated 54 displaced transverse fractures of the patella at our institution. We segregated the patients into two groups: Group 1 (n=23) included fractures treated with tension band wiring (TBW) along with augmented circumferential cerclage wiring while as Group 2 (n=31) included fractures treated by TBW alone. Outcome was studied, graded and compared on the basis of knee pain, knee stiffness, quadriceps wasting, loss of flexion and loss of extension. Results: 73.90% patients among group 1 and 70.96% among group 2 showed excellent to good results (P value < 0.1). Fixation failure and need for revision surgery among group 1 and group 2 was found to be 8.69% and 9.67%, respectively (P value < 0.6). Infections and non union occurred among 4.34% patients in group 1 whereas in group 2 it was 6.45% of the patients who encountered the same (P value < 0.6). Conclusions: The use of circumferential cerclage wiring along with tension band wiring for displaced transverse fractures of patella seems to have no added advantage over fixation with tension band wiring alone.Keywords: Patella fracture, Tension band wiring, cerclage wiring 

scholarly journals Role of screw proximity in the fixation of transverse patellar fractures with screws and a wire

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901878970 ◽  
Author(s):  
Chih-Wei Chang ◽  
Yen-Nien Chen ◽  
Chun-Ting Li ◽  
Yu-Hsuan Chung ◽  
Chih-Han Chang ◽  
...  
Keyword(s):  
Numerical Study ◽  
Steel Wire ◽  
Leading Edge ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Cannulated Screws ◽  
Bone Contact ◽  
Deep Placement ◽  
Screw Insertion ◽  
Biomechanical Responses

Purpose: Clinical and biomechanical studies have reported that using supportive screws and a wire instead of the common Kirschner wires for modified tension band wiring improves the stability of fractured patellae. However, the effect of screw proximity on the fixation of a fractured patella remains unclear. Therefore a numerical study was conducted to examine the effects of screw proximity on biomechanical responses in a simulated patellar fracture fixed using two parallel cannulated screws and anterior tension band wiring. Methods: A patellar model with a transverse fracture and loads simulating patellar tendon forces applied on the patella were used in the present simulation. The surgical fixation consisted of two 4.0-mm parallel partially threaded cannulated screws with a figure-of-eight tension band made using a 1.25-mm stainless steel wire. Biomechanical responses at two screw proximities, 5 and 10 mm from the leading edge of the patella, were investigated. Results: Superficial screw placement (5 mm) yielded higher stability, lower wire loads, and lower bone contact pressures than the deep placement (10 mm). The deep placement of screws exerted a higher load on the wire but a lower force on the screw than superficial placement did. Conclusion: This is the first numerical study to examine the effects of screw location on the fixation of a fractured patella using cannulated screws and tension band wiring. Considering the favorable biomechanical responses, superficial placement (5 mm below the leading edge of the patella) is recommended for screw insertion when treating a transverse fractured patella.

Tension Band Wiring of Unstable Transverse Fractures of the Proximal and Middle Phalanges of the Hand

2004 ◽  
Vol 29 (2) ◽  
pp. 130-134 ◽  
Author(s):  
O. PEHLIVAN ◽  
A. KIRAL ◽  
C. SOLAKOGLU ◽  
I. AKMAZ ◽  
H. KAPLAN
Keyword(s):  
Functional Outcomes ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Fracture Line ◽  
Kirschner Wires ◽  
Shaft Fractures ◽  
Transverse Fractures

Twenty-three isolated, unstable and closed transverse middle and proximal phalangeal shaft fractures in 23 patients were treated by tension band wiring. The tension band was applied with two transverse Kirschner wires that did not cross the fracture line. All of the fractures united and achieved satisfactory functional outcomes. No patient required either physiotherapy or tenolysis or capsulotomy surgery.

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