Tension Band Wiring for Fracture Patella Outcome with 3 K Wire versus 2 K Wire

Introduction: Fractures of the patella constitute almost 1% of all skeletal injuries, resulting from either direct or indirect trauma. Many forms of internal fixation for patellar fractures have been described in the literature but perfect anatomical reduction during surgery has an excellent outcome irrespective of the method of fixation used. The conventional method of patellar tension band wiring is always done with the help of two parallel Kirschner wires. Here, in our study, we intended to see whether the use of 3 parallel Kirschner wires in comparison to conventional one results in a superior functional outcome. Methods: A prospective observational study was carried out in ANIIMS and GB Pant hospital Port Blair from November 2016 to November 2019 on 44 patients of patellar fracture operated by tension band wiring with 22 patients in 2 parallel Kirschner wires and 3 parallel Kirschner wires groups respectively. Results: 44 patients were followed up postoperatively for 1 year and assessed by Lysholm knee score for pain status and working status and other variables. The mean age of the participants was 40.27 years (41.86 in two Kirschner wire group and 38.68 in three Kirschner wire group) in our study. Lysholm knee score, pain status, or working status was not significant throughout the mean follow-up periods for both groups. Conclusions: We found no significant difference between patellar TBW in 3 Kirschner wire and 2 Kirschner wire groups. However small sample size limits our study.

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Comparison of the outcomes of pull through suturing vs. tension band wiring fixation techniques in the management of patellar fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20181045 ◽

2018 ◽

Vol 4 (3) ◽

pp. 502

Author(s):

Rahul Kadam ◽

Sachin Pandey ◽

Abhay Challani ◽

Vicky Jain ◽

Akshay Shah ◽

...

Keyword(s):

Standard Of Care ◽

Tension Band ◽

Tension Band Wiring ◽

Knee Score ◽

Number Of Patients ◽

Lysholm Knee Score ◽

Fixation Techniques ◽

The Mean ◽

Pull Through ◽

Patellar Fractures

Background: Operative fixation of displaced patella fractures has now become the standard of care. This study aims to asses functional outcomes, as well as identify complications in a patients treated with non-absorbable braided suture fixation for patellar fractures. These patients were then compared to a group of patients treated with K-wires with tension band wiring.Methods: This study was conducted on the patients admitted to orthopaedic ward at MGM medical college and hospital, Kamothe, Navi Mumbai. Total number of patients was taken for this study. Patients were followed up for a period of 6 weeks, 3 months, 6 months and at each visit. Patients were assessed by Lysholm knee score.Results: The mean age was 43.33 years for TB wiring group and 46.26 years for pull through suturing group. Out of 30, 15 were in TB wiring group in which 14 males and 1 female and, 15 in pull through suturing group 4 females and 11 males. The mean Lysholm knee score at 6 weeks for TB wiring group was 68.2 at 3 months was 81.4 at 6 months was 87. The mean Lysholm knee score for 6 weeks for pull through suturing was 69.2, at 3 months was 72.5 and at 6 months was 79.2.Conclusions: Patella fracture most common fractures, in this study we have discussed two modalities of treatment one is TB wiring and second is pull through suturing showing results that TB wiring have better results.

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BIOMECHANICAL ASSESSMENT OF TENSION-BAND WIRING FOR OLECRANON FRACTURES

Biomedical Engineering Applications Basis and Communications ◽

10.4015/s1016237211002402 ◽

2011 ◽

Vol 23 (01) ◽

pp. 83-87 ◽

Cited By ~ 1

Author(s):

Chien-Chung Kuo ◽

Horng-Chaung Hsu ◽

Shih-Wun Hong ◽

Tung-Wu Lu

Keyword(s):

Migration Rate ◽

Kirschner Wire ◽

Tension Band ◽

Tension Band Wiring ◽

Union Rate ◽

Kirschner Wires ◽

Biomechanical Assessment ◽

K Wires ◽

Radiographic Union ◽

Olecranon Fractures

Tension-band wiring is the preferred method of treatment for olecranon fractures and is widely used throughout the world. This technique simply and effectively transforms the forces produced by the pulling of the triceps into forces causing compression of the fracture. Although the procedure is associated with a high union rate, the incidence of skin complications is also high. The most frequent complication is symptomatic prominence of the Kirschner wires (K-wires). The purpose of this retrospective study was to identify the optimal fixation of tension-band wiring in the treatment of olecranon fractures using biomechanical techniques. Sixty-two patients were divided into two groups: a bicortical Kirschner wire group and an intramedullary K-wire group. The migration rate of the K-wires and the union rate of fractured bone were measured in both groups. Achievement of radiographic union was similar in the two groups. However, the K-wire migration rate was higher in the intramedullary K-wire group than in the bicortical K-wire group. With appropriate surgical technique, the use of bicortical K-wires is biomechanically superior to the use of intramedullary K-wires in the treatment of olecranon fractures.

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Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins

Journal of Orthopaedic Surgery ◽

10.1177/2309499019882140 ◽

2019 ◽

Vol 27 (3) ◽

pp. 230949901988214 ◽

Cited By ~ 1

Author(s):

Kyung-Hag Lee ◽

Yohan Lee ◽

Young Ho Lee ◽

Bong Wan Cho ◽

Min Bom Kim ◽

...

Keyword(s):

Daily Activity ◽

Failure Load ◽

Dynamic Test ◽

Tension Band ◽

Tension Band Wiring ◽

Transverse Fracture ◽

Kirschner Wires ◽

Static Test ◽

Significant Difference ◽

The Mean

Purpose: The purpose of this study is to compare biomechanical characteristics of tension band wiring using Kirschner wires (TBWKW), cannulated screws (TBWCS), and ring pins (TBWRP) for transverse fracture of the patella. Methods: A total of 48 polyurethane synthetic patellae were biomechanically tested. All patellae were osteotomized to create a transverse fracture. Each TBWKW, TBWCS, and TBWRP fixed 16 broken patellae. A specially designed fixation board simulated a knee with 90° flexion. Ten static tests and six dynamic tests were performed on each method. The static test is measuring maximum strength ( N) during traction until breakage of the fixation. The dynamic test consisted of measuring the fracture gap (mm) after 10,000 repetitive loading cycles between 100 N and 300 N that simulated actual daily activity. A gap of 2 mm or more was defined as a failure in both tests. Result: The failure load was 438.6 ± 138.6 N, 422.2 ± 72.7 N, and 1106.8 ± 230.3 N for TBWKW, TBWRP, and TBWCS, respectively. TBWCS showed a statistically significant difference compared to TBWKW and TBWRP in the static test ( p < 0.001). All the groups had no failure in the dynamic test. The mean fracture gap after completion of the dynamic test was 0.3267 ± 0.3395 mm, 0.2938 ± 0.2165 mm, and 0.0360 ± 0.0570 mm for TBWKW, TBWRP, and TBWCS, respectively ( p = 0.044). The mean values in the dynamic test showed no statistical difference. There was a significant difference between TBWRP and TBWCS ( p = 0.009), but others showed no difference with statistical significance. Conclusion: All three methods have sufficient stability at a daily activity. TBWCS showed a better failure load compared with TBWKW and TBWRP. TBWRP showed compatible mechanical characteristics with traditional tension band wiring. TBWRP could be an alternative method for TBWKW.

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A SIMPLE METHOD OF OSTEOSYNTHESIS FOR AVULSION FRACTURES OF THE THUMB METACARPOPHALANGEAL JOINT

Hand Surgery ◽

10.1142/s021881040500284x ◽

2005 ◽

Vol 10 (02n03) ◽

pp. 209-211

Author(s):

Kentaro Watanabe

Keyword(s):

Internal Fixation ◽

Avulsion Fracture ◽

Kirschner Wire ◽

Metacarpophalangeal Joint ◽

Tension Band ◽

Tension Band Wiring ◽

Simple Method ◽

Avulsion Fractures ◽

Pull Out ◽

Thumb Metacarpophalangeal Joint

Five cases with an avulsion fracture of the thumb metacarpophalangeal joint treated by a simple method of internal fixation are described. This method is designed as a form of modified tension band wiring using the combination of a single Kirschner wire and a pull-out wire, and is technically easy.

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Medial Humeral Epicondylar Fracture in Children and Adolescents

Journal of Orthopaedic Surgery ◽

10.1177/230949900701500209 ◽

2007 ◽

Vol 15 (2) ◽

pp. 170-173 ◽

Cited By ~ 25

Author(s):

D Ip ◽

WL Tsang

Keyword(s):

Treatment Outcomes ◽

Mayo Clinic ◽

Kirschner Wire ◽

Young Patients ◽

Tension Band ◽

Kirschner Wires ◽

Range Of Movement ◽

Cubitus Valgus ◽

Tension Band Wire ◽

Displaced Fracture

Purpose. To assess treatment outcomes of young patients with medial epicondylar fracture of the elbow using standard operative protocols. Methods. 24 consecutive patients with medial humeral epicondylar fracture underwent surgery by one of the 3 methods: (1) 2 parallel Kirschner wires, (2) 2 parallel Kirschner wires plus a tension-band wire, and (3) a screw plus an anti-rotation Kirschner wire. Fractures displaced less than 5 mm were treated conservatively (casting for 3 weeks). Outcome was assessed clinically and radiologically. The Mayo Clinic Elbow Performance Index was measured. Results. The 3 patients with undisplaced fractures had good radiological results and scores. One patient with a displaced fracture refused surgery and subsequently developed pseudarthrosis and cubitus valgus. All operatively treated patients had good scores, but 2 treated with 2 parallel Kirschner wires alone developed pseudarthrosis. Patients in this group needed longer rehabilitation to attain a functional range of movement than those in other groups (treated together with a tension-band wire or screw). Conclusion. Surgery is recommended for children with displaced medial epicondylar fractures of more than 5 mm. The use of a tension-band wire, instead of a screw, together with Kirschner wires is the preferred treatment for younger children.

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Evaluation of the Results of Arthroscopic Release in Limits of Movement in Knees

Journal of Shahid Sadoughi University of Medical Sciences ◽

10.18502/ssu.v27i9.2308 ◽

2020 ◽

Author(s):

Mohammad Reza Sobhan ◽

Seyed Hossein Saeed Banadaky ◽

Mohammad Shafiee ◽

Mohammad Gheisari

Keyword(s):

Statistical Tests ◽

Cross Sectional Study ◽

Knee Score ◽

Cross Sectional ◽

Mean Values ◽

Arthroscopic Release ◽

Lysholm Knee Score ◽

Significant Difference ◽

Before And After ◽

The Mean

Introduction: Limits of movement in knees is one of the most common complications following trauma and surgery. With early diagnosis and appropriate treatment choices, knee replacement and performance improvement are expected in many patients. However, limits of movement in knees is unpleasant and should be corrected as soon as possible. In this study, we decided to evaluate the results of arthroscopic release in motion limits of knees. Methods: This was a descriptive cross-sectional study.14 patients who referred to the Shahid Sadoughi Hospital of Yazd from 2014 to 2016 and diagnosed with knee limitation (flexion or extension restriction of more than 10 degrees) were selected. Patients were undergone arthroscopic release and followed-up for 6 months. Lysholm knee score, degrees of flexion and extension, and patient satisfaction were evaluated. The results were analyzed by SPSS-18 and statistical tests Paired T-test as well as Spearman correlation. Results: The mean age of the patients was 28.92±10.99 years. The most common type of trauma in the patients was femoral distal fracture (46.7%). The frequency of the patients' satisfaction with arthroscopy was as followed: 50% (7 patients), had moderate satisfaction, 28.6% (4 ones), high satisfaction, and 21.4% (3 ones) had low satisfaction.The mean difference in Lysholm Knee Score, improvement in degree of extension, improvement in degree of flexion and pain score before and after arthroscopy were 26.21±14.11,64.78±26.13,3.57±2.92 and 4.13±1.65,respectively.There was a significant difference between the mean values of these factors before and after arthroscopy. Conclusion: According to the results obtained, we can conclude that arthroscopic release is an effective and low-complication method in motion limits of knees.

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Is radiofrequency use in arthroscopic treatment of isolated medial meniscus horizontal cleavage tears more effective than mechanical debridement in young adults?

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh200225076k ◽

2020 ◽

pp. 76-76

Author(s):

Özgür Korkmaz ◽

Uğur Kasman ◽

Sıtkı Çeçen

Keyword(s):

Clinical Outcomes ◽

Medial Meniscus ◽

Knee Score ◽

Arthroscopic Partial Meniscectomy ◽

Vas Score ◽

Bipolar Radiofrequency ◽

Lysholm Knee Score ◽

The Mean ◽

Early Clinical Outcomes

Introduction/Objective. Arthroscopic mechanical hand tools, motorized shavers, and bipolar radiofrequency are used in arthroscopic partial meniscectomy. The aim of this study is to evaluate efficacy of radiofrequency on early clinical outcomes in patients who underwent arthroscopic partial meniscectomy with horizontal cleavage tear and without additional intraarticular knee pathology. Methods. A total of 37 patients complied with the study criteria. Patients were divided into two groups according to usage of bipolar radiofrequency. Patients were evaluated by using visual analog scale (VAS) and Tegner Lysholm knee scores at the end of the first year follow-up. Results. Twenty-two patients comprised the shaver-using group. Preoperative mean VAS score was 7.9 ? 0.8, and the Tegner Lysholm knee score was 49.6 ? 9.6. Fifteen patients comprised the bipolar radiofrequency-using group. Preoperative VAS score was 7.8 ? 0.9, and the Tegner Lysholm knee score was 52.2 ? 10.7. The mean VAS score was 1.2 ? 0.9, and the mean Tegner Lysholm knee score was 89.5 ? 8.1 in shaver used group at last follow-up. At the last postoperative follow-up, the mean VAS score was 1.1 ? 1, and the Tegner Lysholm knee score was 88.8 ? 7.3 in the bipolar radiofrequency-using group. No statistically significant differences between the VAS and Tegner Lysholm knee scores of the preoperative and postoperative controls of the two groups were observed (p?0.05). Conclusion. Radiofrequency use has no effect on early clinical outcomes in the arthroscopic treatment of isolated medial meniscus posterior horn horizontal cleavage tears; we do not recommend its use

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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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PEAK LOAD RESISTANCE OF THE JUGGERKNOTXS™ SOFT ANCHOR TECHNIQUE COMPARED WITH OTHER COMMON FIXATION TECHNIQUES FOR LARGE MALLET FINGER FRACTURES

Hand Surgery ◽

10.1142/s0218810413500433 ◽

2013 ◽

Vol 18 (03) ◽

pp. 381-388

Author(s):

Jason Pui Yin Cheung ◽

Boris Fung ◽

Wing Yuk Ip

Keyword(s):

Kirschner Wire ◽

Peak Load ◽

Load Resistance ◽

Tension Band ◽

Tension Band Wiring ◽

Fixation Method ◽

Mallet Finger ◽

Pull Out ◽

Fixation Techniques ◽

Anchor Fixation

Introduction: To identify the strongest peak load resistance among four mallet finger fracture fixation methods (Kirschner wire, pull-out wire, tension-band wiring and the JuggerKnot™ (Biomet) soft anchor fixation). Methods: Fixation techniques were assigned among 24 specimens from six cadaveric human hands in a randomized block fashion. Peak load resistance was tested at 30°, 45° and 60° of flexion of the distal interphalangeal joint. Results: The mean peak load of tension-band wiring was 67.8 N at 60° of flexion which was most superior. The JuggerKnot™ fixation had mean peak loads of 13.35 N (30°), 22.51 N (45°) and 32.96 N (60°). No complications of implant failure or fragmentation of the dorsal fragment was noted. Conclusions: Tension-band wiring was the strongest fixation method but was most prominent on the skin surface as seen in three specimens. The JuggerKnot™ soft anchor fixation had similar peak load resistance as k-wire fixation and pull-out wiring.

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All-Inside Arthroscopic Repair For Longitudinal Meniscal Tears: Clinical and Functional Results

Surgical Technology Online ◽

10.52198/21.sti.38.os1396 ◽

2021 ◽

Author(s):

Stefano Grossi ◽

Edoardo Ipponi ◽

Eric Bufalino ◽

Gabriele Gariffo ◽

Gabriele Filoni ◽

...

Keyword(s):

Functional Outcomes ◽

Meniscal Tear ◽

Meniscal Repair ◽

Functional Results ◽

Repair System ◽

Knee Score ◽

Meniscal Tears ◽

Lysholm Knee Score ◽

Arthroscopic Meniscectomy ◽

The Mean

Meniscal injuries are a common challenge in orthopaedic surgery. Depending on their location and the patient’s age and functional needs, they can be treated either conservatively or surgically. A surgical approach can consist of arthroscopic meniscectomy or meniscal suture. The latter is the treatment of choice in case of lesions involving the red-red or red-white areas of the meniscus, especially for young high-demanding patients. We report here our experience with the repair of longitudinal meniscal tears using the all-inside technique with the Fast-Fix™ 360 Meniscal Repair System (Smith & Nephew Endoscopy, Andover, MA). We retrospectively evaluated 20 consecutive cases of longitudinal meniscal tears. In 4 cases, concomitant ACL rupture was diagnosed and treated alongside the meniscal repair. All patients underwent periodic clinical evaluations. At the latest check-up, their functional outcomes were rated according to the Tegner-Lysholm Knee and KOOS scoring scales. The mean Tegner-Lysholm Knee score was 84.85 (44-100) and the mean KOOS score was 88.58. No failure or major complications were observed. Furthermore, a negative statistical association was observed between age at surgery and the post-operative Tegner-Lysholm Knee score (coef. = -1.01189 [-1.942073,-0.0817063], p = 0.035). This relation, independent of gender, meniscus involved, eventual associated ACL reconstruction, and chondral injury, suggests that functional outcomes worsen with increasing patient age. Our results suggest that the arthroscopic all-inside suture is both safe and effective in cases of longitudinal meniscal tear, considering the good post-operative functionality and low rates of local complications and surgical failures.

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