Study of Fracture Patella with Tension Band Wiring

Background: Fractures of the patella are serious injuries with a broad range of subtypes. These injuries account for about 1% of all skeletal injuries and are most prevalent within the age group of 20-50 years. The underlying mechanisms of open fractures are mostly high-velocity accidents. To assess the functional outcome of various surgical procedures done for fracture patella.Methods: A longitudinal study was conducted from the department of orthopedics, Vinayaka missions Kirupananda Variyar medical college and hospital, Salem for one year in August 2019 and July 2020. All the adult patients admitted with the diagnosis of patellar fracture were included in the study. A complete local examination was conducted and an X-ray of AP and the lateral view was taken for all the patients.Results: Transverse patella fracture is being the most common fracture and for that modified tension band wiring (TBW) was the most common procedure performed and for comminuted fracture partial patellectomy was the most common procedure and for 1 patient total patellectomy was performed.Conclusions: The study shows that the treatment of patella fractures with modified tension band wiring is a definitive treatment with minimal complications and excellent functional outcomes.

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Evaluation of Functional Outcome of Patients with Transverse Fracture of Patella Treated with Tension Band Wiring - A Prospective Study Conducted at Trichur, Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/506 ◽

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

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A CLINICAL STUDY OF SURGICAL MANAGEMENT OF FRACTURE PATELLA WITH MODIFIED TENSION BAND WIRING

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2017/755 ◽

2017 ◽

Vol 4 (63) ◽

pp. 3782-3785

Author(s):

Yerakula Ramana ◽

Dema Rajaiah ◽

Kuppa Srinivas ◽

Kolathuru Sudhaker ◽

Bommala Sivaiah ◽

...

Keyword(s):

Clinical Study ◽

Surgical Management ◽

Tension Band ◽

Tension Band Wiring ◽

Fracture Patella

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A comparative study of tension band wiring and encirclage in treating transverse fractures of patella

International Surgery Journal ◽

10.18203/2349-2902.isj20171517 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1558

Author(s):

Subrat Mohapatra ◽

Pulin Bihari Das ◽

R. V. Krishnakumar ◽

Sibanarayan Rath ◽

Rabindra N. Padhy

Keyword(s):

Full Range ◽

Early Mobilization ◽

Tension Band ◽

Tension Band Wiring ◽

Transverse Fracture ◽

Radiological Outcome ◽

Operative Complications ◽

Fracture Patella ◽

Group A ◽

Transverse Fractures

Background: The functional and radiological outcome of the union of transverse fractures of patella treated by tension band wiring (TBW) and encirclage wiring were compared according to WEST’s criteria.Methods: During three years, 44 patients with displaced transverse fracture patella were treated randomly either by TBW or encirclage with twenty-two patients in each group. Two patients in each group were lost to follow-up.Results: Results were compared based on the period of union, post-operative complications, early mobilization and recovery to pre-injury level. Fractures united at an average of 13.6 weeks with 8-12 and 10-14 weeks in TBW and the encirclage group, respectively. Results were excellent in 65%, good in 25% and poor in 10% cases in TBW group, as compared to the encirclage group with excellent in 50%, good in 30% and poor in 20% cases. In TBW group, 75% cases had a full range of motion (ROM), 15% had >120° of flexion and 10% had flexion between 90° and 120°, as compared to 50% full ROM, 30% >120° of flexion and 20% between 90° and120° flexion in the encirclage group. A case of migration of pin and another case of limitation of flexion by 25° were noticed.Conclusions: Patients treated with TBW had better results than the encirclage in the management of transverse fractures of the patella.

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