Internal Fixation of Transverse Patella Fractures Using Cannulated Cancellous Screws with Anterior Tension Band Wiring

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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Open Reduction and Internal Fixation of Patellar Fractures with Tension Band Wiring through Cannulated Screws

The Journal of Knee Surgery ◽

10.1055/s-0033-1364100 ◽

2014 ◽

Vol 27 (05) ◽

pp. 377-382 ◽

Cited By ~ 6

Author(s):

Manzoor Halwai ◽

Mudasir Malik

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Tension Band ◽

Tension Band Wiring ◽

Cannulated Screws ◽

Patellar Fractures

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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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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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Modification of tension band wiring of displaced intra-articular phalangeal fractures

Canadian Journal of Plastic Surgery ◽

10.1177/229255039600400304 ◽

1996 ◽

Vol 4 (3) ◽

pp. 1-3

Author(s):

Margaret Pugh ◽

Robert S Richards

Keyword(s):

Stainless Steel ◽

Internal Fixation ◽

Steel Wire ◽

Tension Band ◽

Tension Band Wiring ◽

Stainless Steel Wire ◽

Percutaneous Pinning ◽

Articular Fractures ◽

Phalangeal Fractures

Numerous techniques have been described for internal fixation of displaced intra-articular fractures of the phalanges, including percutaneous pinning, microplating, interosseous wiring and tension banding techniques. One method, described by Rayhack and Bottke, is a modified tension banding method using a K-wire and a stainless steel wire. Although this technique has been found to be very useful, certain complications have led to the development of a modification of this technique.

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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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Outcome of Inferior Patellar Pole Avulsion Fractures

Journal of Lumbini Medical College ◽

10.22502/jlmc.v4i2.97 ◽

2016 ◽

Vol 4 (2) ◽

pp. 84

Author(s):

Ruban Raj Joshi ◽

Rajeev Dwivedi ◽

Subin Byanjankar ◽

Rahul Shrestha

Keyword(s):

Internal Fixation ◽

Hospital Stay ◽

Open Reduction ◽

Tension Band ◽

Tension Band Wiring ◽

Patellar Ligament ◽

Suture Repair ◽

Avulsion Fractures ◽

Inferior Pole ◽

Tension Band Wire

Introduction: The optimal treatment for inferior pole patella avulsion fractures has still been a topic of debate. The options include (a) internal fixation of the pole fragment and (b) resection of the avulsed fragment and repair of the patellar ligament to the patella. We present the comparative outcomes for patients with displaced inferior pole patella treated by resection and transosseous Ethibond® Krackow suture repair of patellar ligament with open reduction and internal fixation with modified tension band wiring and circumferential wiring. Methods: During a three year period between August 2013 and September 2016, twenty consecutive patients with distal pole fractures of the patella were prospectively enrolled in this study. These patients were divided into two groups. Group-T patients were treated with open reduction and internal fixation with modified tension band wire and group-R patients by resection of the avulsed fragment and reattachment of the patellar ligament to the patella with #5 Ethibond®. Data entry and analysis was done by using SPSS version 20. Anatomical and functional outcome were compared. Results: Consecutive 20 patients were treated either with resection lower patellar pole (n=10) or with open reduction internal fixation with tension band wiring (n=10). Demographics were matched in two groups. Group-T required a longer hospital stay (U=13.5, p=0.005). Complications were seen more often in Goup-T compared to Group-R (p=0.005). Group-R had better scores (Bostman score U=6, p=0.001; SFMA U=7.5, p=0.001) and range of movement (p<0.05). Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had better outcome according to the Bostman and SFMA dysfunction score, shorter hospital stay, and less complications as compared to open reduction and internal fixation with tension band wire and circumferential wiring.

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Comparative study of tension band wiring and pre contoured locking compression plate fixation in olecranon fractures in adults

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211932 ◽

2021 ◽

Author(s):

Mohit Mahoviya ◽

Pradeep Choudhari ◽

Divyanshu Patel ◽

Arpit Choyal

Keyword(s):

Comparative Study ◽

Internal Fixation ◽

Plate Fixation ◽

Tension Band ◽

Tension Band Wiring ◽

Improvement Rate ◽

Articular Fractures ◽

Group A ◽

Group B ◽

Olecranon Fractures

Background: Olecranon fractures are about 10% of all proximal forearm fractures.Mostly intra articular fractures, require anatomical reduction and internal fixation for satisfactory clinical outcomes. The most commonly used techniques are still tension band wiring (TBW) and plate fixation (PF). The aim of the current study is to discuss whether TBW or PF technique of internal fixation is better in the treatment of olecranon fractures.Methods: This is a comparative study including 30 adult patients of olecranon fracture classified by Mayo classification and operated upon by tension band plating (group A) and tension band wiring (group B) at Department of Orthopaedics, Sri Aurobindo Medical College and PG Institute, Indore. All operated cases between the period of January 2018 to August 2019 with follow up of 1 year were assessed on the basis of functional outcome using Mayo elbow performance score (MEPS).Results: The MEPS, 73% of the patients in group A achieved a good to excellent results in comparison to 60% in group B. no significant differences between the two groups could be detected regarding the clinical and radiographic outcome.Conclusions: Both TBW and PF interventions had treatment benefit in OFs. The current study reveals that there are no significant differences in MEPS, improvement rate and ROM between TBW and PF for OFs. More high-quality studies are required to further confirm our results as most of the cases included in study belonged to Mayo type IIA category.

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