Comparative study of Modified Tension Band Wiring versus Tension Band Through Parallel CannulatedCancellous Screws in Patella 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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Comparative study of management of olecranon fractures using tension band wiring technique with cancellous screw and K wires

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20162840 ◽

2016 ◽

Vol 2 (3) ◽

pp. 109

Author(s):

Krishnaprasad H. S. ◽

Shivanna Shivanna

Keyword(s):

Comparative Study ◽

Clinical Results ◽

Tension Band ◽

Tension Band Wiring ◽

Cancellous Screw ◽

Medical College ◽

Prospective Comparative Study ◽

Group 5 ◽

K Wires ◽

Olecranon Fractures

Background: Olecranon fractures are commonly seen injuries in the emergency room. The surgical management of displaced fractures is open reduction and internal fixation with k-wires and figure of eight tension band wiring. It can also be fixed with intramedullary cancellous screw with tension band wiring. The present study is to compare the results of both the surgical procedures and to assess the merits and demerits.Methods: This prospective comparative study was carried out from August 2012 to November 2013 in Bapuji Hospital and Chigateri General Hospital attached to J.J.M Medical College, Davangere, India, where among 20 olecranon fractures, ten were treated with Tension band wiring with Kirshner wire and another ten treated with intramedullary cacellous screw with tension band wiring and the results were evaluated and compared.Results: In our study, most of the cases were type II B fractures according to Colton’s classification. According to Mayo elbow performance score, Excellent results found in 8 patients (80%), good in1patient (10%) and fair in 1 patient (10%) in cancellous screw group and in K wire group, 5 patient (50%) had excellent, 3 patient (30%) had good and 2 patients (20%) had fair results. No poor result was seen in both groups.Conclusions: From this study it is concluded that using cancellous screw with tension band wiring for displaced transverse and oblique olecranon fractures gives better clinical results when compared to tension band wiring with K-wire fixation avoiding cost, work time loss and possible complications from hard ware removal.

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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

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-012-1999-1 ◽

2012 ◽

Vol 21 (2) ◽

pp. 311-317 ◽

Cited By ~ 28

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

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Complications Related to Implant Fixation of Patellar Fractures: Comparison of Ring Pins versus Bent K-Wires

The Journal of Knee Surgery ◽

10.1055/s-0036-1593621 ◽

2016 ◽

Vol 30 (06) ◽

pp. 560-564 ◽

Cited By ~ 4

Author(s):

Min Kyung ◽

Seung Lee ◽

Min Kim

Keyword(s):

Tension Band ◽

Implant Removal ◽

Tension Band Wiring ◽

The Novel ◽

Implant Migration ◽

Group 2 ◽

K Wires ◽

Patellar Fractures ◽

Ring Pin ◽

Group 1

AbstractPatellar fractures are characterized by injuries to the extensor and typically require surgical fixation. Among the methods used for fixation, the most common is the modified AO tension-band wiring technique. However, using this technique, implant migration occurs due to the lack of connections between the K-wires and the tension-band wire, which causes irritation and reduces fracture stability. Recently, new methods for tension-band wiring have been developed in which tension bands lock the K-wires through an attached “ring” to prevent migration. The purpose of this study was to compare the clinical outcomes when either the conventional or novel technique was used for tension-band wiring. This was a retrospective study involving 48 patients who underwent tension-band wiring to correct a patellar fracture. Patients in group 1 (n = 23) were treated between December 2010 and February 2012 using conventional tension-band wiring, while patients in group 2 (n = 25) were treated between March 2012 and May 2014 using the novel ring pin method. Different surgeons performed the operations in the two groups, while all other conditions were consistent. The surgical outcomes were assessed according to the level of implant migration, irritation, and implant removal procedures. All patients in group 2 achieved a union of the patella, while two patients in group 1 did not. These two patients underwent partial patellectomy within 1 year of the initial surgery. Implant migration and removal were significantly more common among patients in group 1 (p = 0.0038 and 0.011, respectively), with the implant removal period being significantly shorter as well (p = 0.005). The novel ring pin method was superior to the conventional method in terms of preventing implant migration, removal, or other secondary operations for the correction of complications.

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A Comparative Study of Functional Outcome of Olecranon Fractures Managed with Tension band Wiring Using K Wires with Tension Band Wiring Using Cancellous Screws Fixation

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i37a31996 ◽

2021 ◽

pp. 193-198

Author(s):

Ashutosh Parate ◽

Vasant Gawande ◽

Suvarn Gupta ◽

Ankit Jaiwal ◽

Ashwin Chavan ◽

...

Keyword(s):

Comparative Study ◽

Road Traffic ◽

Tension Band ◽

Tension Band Wiring ◽

Cancellous Screw ◽

Medical College ◽

Prospective Comparative Study ◽

Cancellous Screws ◽

K Wires ◽

Olecranon Fractures

Introduction: Olecranon fracture are some of the common injuries seen in emergency with commonest mode of trauma being fall on outstretched hand and road traffic accident. Methods: This prospective comparative study was carried out from May 2020 to May 2021 within a study period of 1 year in Datta Meghe Medical College. 20 patients of olecranon fractures were enrolled randomly. Results: According to the Mayo classification, the majority of the cases in our study were type II A fractures. The Mayo elbow performance score. In the K wire category, 5 patients (50%) had excellent results, 3 patients (30%) had decent results, and 2 patients (20%) had fair results. In both categories, there were no negative repercussions. In the cancellous screw category, excellent results were found in 8 patients (80%), nice in 1 patient (10%), and fair in 1 patient (10%). Conclusions: From this study, we came to the conclusion that for displaced olecranon fractures as per Mayo’s II A classification fixed by using cancellous screw with tension band wiring gives better clinical outcome When compared to tension band wiring, K-wire fixation keeps costs down, time, and the chance of implant removal complications.

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Management of patella fractures with different modalities

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191455 ◽

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

Background: 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.Methods: 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.Results: Total 20 patella fractures were included in this study. 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.Conclusions: We conclude that compared with the MKTB technique, CSTB fixation is an effective surgical procedure for treatment of displaced transverse patellar fractures.

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Fixation of Closed Transverse Patella Fracture with Cannulated Cancellous Screws and Anterior Tension Band Wiring- A Prospective Study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.4723 ◽

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.

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Intramedullary screw fixation for simple displaced olecranon fractures

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-019-01114-4 ◽

2019 ◽

Vol 46 (1) ◽

pp. 83-89 ◽

Cited By ~ 1

Author(s):

Willem-Maarten P. F. Bosman ◽

Benjamin L. Emmink ◽

Abhiram R. Bhashyam ◽

R. Marijn Houwert ◽

Jort Keizer

Keyword(s):

Soft Tissue ◽

Plate Fixation ◽

Cannulated Screw ◽

Tension Band ◽

Tension Band Wiring ◽

Hardware Removal ◽

Dash Score ◽

Intramedullary Screw ◽

Olecranon Fractures

Abstract Purpose Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of implant-related soft-tissue irritation. Another treatment option is fixation with an intramedullary screw, but less is known about surgical results using this strategy. Thus, the purpose of this study was to report the clinical and functional outcomes of olecranon fractures treated with an intramedullary cannulated screw. Methods We identified 15 patients (average age at index procedure 44 years, range 16–83) with a Mayo type I or IIA olecranon fracture who were treated with an intramedullary cannulated screw at a single level 2 trauma center between 2012 and 2017. The medical record was reviewed to assess radiographic union, postoperative range of motion and complications (including hardware removal). Patient-reported outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Average follow-up was 22 months (range 8–36 months). Results By the 6th month post-operative visit, 14 patients had complete union of their fracture and 1 patient had an asymptomatic non-union that did not require further intervention. Average flexion was 145° (range 135–160) and the average extension lag was 11° (range 0–30). Implants were removed in 5 patients due to soft-tissue irritation. Average DASH score (± standard deviation) by final follow-up was 16 ± 10. Conclusions Fixation of simple olecranon fractures with an intramedullary screw is a safe and easy fixation method in young patients, leading to good functional and radiological results. Compared to available data, less hardware removal is necessary than with tension-band wiring or plate fixation.

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The modified anterior ellipsoidal cap titanium cable tension band for comminuted patellar fractures

Journal of Orthopaedic Surgery ◽

10.1177/2309499019874018 ◽

2019 ◽

Vol 27 (3) ◽

pp. 230949901987401

Author(s):

Fasheng Wang ◽

Tianyi David Luo ◽

Chunyong Chen ◽

Yun Xie ◽

Zhangxiong Lin ◽

...

Keyword(s):

Weight Bearing ◽

Tension Band ◽

High Rate ◽

Wound Complications ◽

Functional Rehabilitation ◽

Postoperative Function ◽

Patella Fractures ◽

The Mean ◽

Patellar Fractures

Purpose: The purpose of this study was to assess the outcomes in a series of patients, who underwent cerclage and figure-of-eight tension band wiring using a single titanium cable for comminuted patellar fractures. Methods: We describe a modified tension band technique using a single titanium cable to create an ellipsoidal cap structure that combines the circumferential and figure-of-eight wrapping in the fixation of closed Association for the Study of Internal Fixation/Orthopaedic Trauma Association 34C2 and 34C3 patellar fractures. We retrospectively reviewed 25 patients (16 males and 9 females, mean age 54 years) who underwent the described fixation technique between 2015 and 2017. Postoperative function was evaluated using the Böstman score. Results: At the mean follow-up of 25 months (range 17–39 months), the mean Böstman score was 27.3 ± 2.6 points (range 23–30). Eighteen patients (72%) had excellent results (score ≥28); seven patients (28%) had good results (score 20–27); and no patients had an unsatisfactory result (score < 20). All surgical incisions healed without major wound complications. Two patients reported minor complications (soft tissue irritation, cellulitis). No patients demonstrated loss of reduction or implant failure during the follow-up period. Conclusion: The modified anterior ellipsoidal cap tension band using a single titanium cable created an effective tension band structure in the treatment of comminuted patella fractures. It is a simple operative technique that produced a stable fixation construct, which allowed early functional rehabilitation and weight-bearing with a high rate of excellent outcomes at 2 years after surgery.

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