scholarly journals Functional outcome of tension band wiring in transverse fracture of medial malleolus

2021 ◽  
Vol 7 (1) ◽  
pp. 98-103
Author(s):  
R Sahaya Jose ◽  
K Visnu ◽  
Shaheen Hameed ◽  
K Vivek
Keyword(s):  
Functional Outcome ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Medial Malleolus ◽  
Transverse Fracture

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 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.

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.

scholarly journals Best technique for fixation of displaced transverse olecranon fractures: tension band wiring or plate fixation?

2020 ◽  
Vol 6 (5) ◽  
pp. 1012
Author(s):  
Lokesh Kumar Yogi ◽  
Gagandeep Mahi ◽  
C. R. Thorat ◽  
Moti Janardhan Naik
Keyword(s):  
Functional Outcome ◽  
Large Scale ◽  
Plate Fixation ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Clinical Event ◽  
Dash Score ◽  
Group A ◽  
Group B ◽  
Olecranon Fractures

<p><strong>Background:</strong> Fractures of olecranon are common fractures in upper limb. Tension band wiring (TBW) and plate fixation (PF) are mostly used techniques but choice is based on type of fracture and surgeon’s preference.</p><p><strong>Methods:</strong>  A study assessed functional results in 28 patients that were enrolled after the clinical event of trauma has occurred. Patients were divided into two groups- Group (A) for TBW and Group (B) for PF; here gender, age and side of fracture were ignored. Post-operative functional outcome were evaluated by using the Mayo Elbow Performance (MEP) and the Disabilities of the Arm, Shoulder and Hand (DASH) score parameters.</p><p><strong>Results:<em> </em></strong>Mean (SD) union time as determined by postoperative radiographs was 8.5 (1.48) weeks for group (A) and 9 (2.08) weeks for group (B). Mean (SD) MEP score at 9 months in group (A) 84.28 (7.28) and 80.71 (10.92) in group (B). Mean (SD) DASH at 9 months in group (A) 12.2 (8.8) and 11.7 (10.4) in group (B). Complications were reported in group (A) 6 patient (42.85%) out of 14 patients and in group (B) 1 patient (7.14%) out of 14 patients.</p><p><strong>Conclusions:<em> </em></strong>The current study shows that there are no significant differences in functional outcome between both the study groups. Due to lesser complications, we recommend the plate fixation approach as the better choice for transverse displaced olecranon fractures. More large scale studies are required to further confirm our results.</p>

scholarly journals Functional Outcome of Revision Osteosynthesis after failed surgical treatment of patellar fractures

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0023
Author(s):  
Elena Müller ◽  
Karl-Heinz Frosch
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Revision Surgery ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Fracture Dislocation ◽  
Secondary Fracture ◽  
Patellar Fractures ◽  
Tegner Score

Aims and Objectives: Patellar fractures account for approximately 1% of all skeletal fractures. They are rare, but due to the crucial function of the patella in the extensor mechanism of the knee they can lead to a serious impairment. New data are revealing functional impairment remains common even with improved surgical techniques. The aim of this study is to asses the functional outcome of patients after revision surgery in case of secondary fracture dislocation or remaining articular incongruity. Materials and Methods: The study was designed as a retrospective observatory study. We included all patients who underwent a revision surgery because of a remaining articular incongruity or a secondary fracture dislocation or re-fracture from January 2010 until december 2016. Results: Sixteen patients of mean age 51,8 years were included in the study with a mean follow-up period of 28,8 months. Fifteen patients had AO type C fractures, within ten a C3 fracture. Thirteen were initially treated with tension band wiring via k-wires or cannulated screws. The reason for a revision surgery were 5 times a remaining articular incongruity, 11 times a secondary fracture dislocation or re-fracture. We analysed pain, satisfaction, range of motion, Böstman-Score, Tegner-Score and KOOS and could extract follow-up data from 15 of the patients. All fractures healed, no articular incongruity remained. Mean pain measured with the visual analogue scale (0-10) was at rest 0,57 (range 0-3,5), on exertion 2,79 (range 0-8). The measurement of the range of motion compared with the opposite knee showed a complete extension. Mean Flexion was 120°, in the opposite knee 136° (p = 0,05). Mean postoperative Böstman-Score and Tegner-Score were 25,11 (good, max. 30) and 78,67 (moderate, max. 100). KOOS: symptoms 66,8 points, pain 77,55 points, ADL 75,67 points and qualitiy of life 56,25 points. Conclusion: Early revision surgery in case of secondary fracture dislocation, re-fracture or remaining articular incongruity leads to statisfactory functional outcomes. Furthermore in case of complexe fractures the tension band wiring technique shouldn’t be the first choice, alternatives like the plate osteosynthesis should be considered.

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