A study of functional and clinical outcome for augmentation plating with tension band wiring for complex patella fractures

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.

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Miniplate Augmented Tension-Band Wiring for Comminuted Patella Fractures

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000001390 ◽

2019 ◽

Vol 33 (4) ◽

pp. e143-e150 ◽

Cited By ~ 2

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

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Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome

Journal of the Korean Fracture Society ◽

10.12671/jkfs.2014.27.2.127 ◽

2014 ◽

Vol 27 (2) ◽

pp. 127 ◽

Cited By ~ 1

Author(s):

Seong Cheol Moon ◽

Chul Hee Lee ◽

Jong Hoon Baek ◽

Nam Su Cho ◽

Yong Girl Rhee

Keyword(s):

Clinical Outcome ◽

Clavicle Fracture ◽

Tension Band ◽

Tension Band Wiring ◽

Distal Clavicle ◽

Distal Clavicle Fracture

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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02656-3 ◽

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.

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Comparison of the efficacy of the tension band wiring with eyelet wire versus anatomical locking plate fixation for the treatment of displaced olecranon fractures

Journal of Orthopaedic Surgery ◽

10.1177/23094990211059231 ◽

2021 ◽

Vol 29 (3) ◽

pp. 230949902110592

Author(s):

Haruhiko Shimura ◽

Akimoto Nimura ◽

Koji Fujita ◽

Hidetoshi Kaburagi

Keyword(s):

Clinical Outcome ◽

Clinical Outcomes ◽

Locking Plate ◽

Plate Fixation ◽

Elbow Flexion ◽

Tension Band ◽

Tension Band Wiring ◽

Locking Plate Fixation ◽

The Mean ◽

Olecranon Fractures

Background This retrospective study was conducted to assess the clinical outcome and complications between tension band wiring (TBW) with eyelet wire and locking plate fixation used for the treatment of displaced olecranon fractures. Methods A total of 58 patients (36 males and 22 females; mean age: 63 years) were reviewed between April 2014 and September 2020. TBW with Ring Pin (RP group) was applied in 24 patients, including 15 Mayo type ⅡA and 9 Mayo type ⅡB patients. Anatomical locking plate (ALP group) was used in 34 patients, including 22 Mayo type ⅡA and 12 Mayo type ⅡB patients. Clinical outcome was evaluated using the Mayo Elbow Performance Score (MEPS), and active range of motion of the elbow and forearm and postoperative complications were reviewed. Results General characteristic of the patients and the fracture type were similar in the two groups. The mean MEPS values were 96.5 ± 7.3 in the RP group and 94.9 ± 9.4 in the ALP group. The mean elbow flexion arc was 127°±11 in the RP group. The mean elbow flexion arc was 122°±18 in the ALP group. No significant differences in clinical outcomes were observed between the two groups. Complication rates were significantly higher in the ALP group (19/34: 56%) than in the RP group (6/24: 25%). Conclusion Although there were no statistically significant differences in clinical outcomes between the two groups, the ALP group had a higher proportion of any complication than the RP group.

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Comparison of Tension-Band Wiring With the Cable Pin System in Patella Fractures

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000000400 ◽

2015 ◽

Vol 29 (12) ◽

pp. e459-e463 ◽

Cited By ~ 13

Author(s):

Qing-xian Tian ◽

Yong Hai ◽

Xin-ru Du ◽

Zi-yu Xu ◽

Tie Lu ◽

...

Keyword(s):

Tension Band ◽

Tension Band Wiring ◽

Patella Fractures

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20182739 ◽

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

Background: 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.Methods: 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.Results: 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 <90, 4 patients had range of motion 90-120 degrees and 24 patients had range of motion >120 degrees. After 1 year, functional outcome was, excellent in 24, good in 4, fair in 1 and poor in 1.Conclusions: 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.

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