A Comparative Study Of Modified Tension Brand Wiring And Cannulated Cancellous Screw Fixation In Management Of Transverse Fractures Of Patella

A Comparative Study Of Modified Tension Brand Wiring And Cannulated Cancellous Screw Fixation

Authors

  • Anand B. Jabshetty

Keywords:

Fractures, Patella, Injuries, cannulated cancellous screw, Quadriceps

Abstract

Background This study compares the results of two commonly used methods of internal fixation for transverse fracture of patella namely modified tension band wiring (TBW) and cannulated cancellous screw fixation. Methodology: The study consists of 20 cases treated at BRIMS hospital , Bidar with modified tension band wiring with K-wires and cannulated cancellous screws with a follow up of 1 year. Out of 20 cases, Group A consists of 10 patients treated for tension band wiring and Group B of 10 cases treated for cannulated cancellous screws. Results: Union was achieved in all 20 cases. Group A treated 9 out of 10 had excellent to good results with knee flexion more than 120° and Group B, had 8 out of 10 with excellent to good results with knee flexion more than 120°. In all the 20 cases Quadriceps wasting was severe but less in Group A. Discussion: Although the modified tension band technique (eg. tension band supplemented by longitudinal Krischner wires) has long been the mainstay for fixation of transverse fractures of patella. It has shortcomings, such as bad reduction, loosening of implants, and skin irritation. It was found that modified tension band wiring showed better results than cannulated cancellous screws as stability of implants is better in transverse fracture patella and post operative rehabilitation is faster. Conclusion The modified tension band wiring is better than that of Cannulated cancellous screw transverse fractures of patella probably because of good stability of implant and easier postoperative rehabilitation. [Jabshetty A NJIRM 2015; 6(4):1-5]

References

1. Gosal HS, Singh P, Field RE. Clinical experience of patellar fracture fixation using metal wire or non-absorbable polyester: a study of 37 cases. Injury. 2001;32:129–135.
2. Berg EE. Open reduction internal fixation of displaced transverse patella fractures with figure-eight wiring through parallel cannulated compression screws. J Orthop Trauma. 1997;11:573–576.
3. Levack B, Flanagan JP and Hobbs S, Results of surgical treatment of patellar fractures. J. Bone Joint Surg. 1985; 67(3): 416-419.
4. Dudani B and Sancheti KH Management of fracture patella by tension band wiring. Indian J. Orthopedics. 1981; 15(1): 4348
5. Srinivaslu K, Sanjiv K, Marya S, Surya Bhan and Dave PK, Results of surgical treatment of patellar fractures. Indian J.Orthop. 1986; 20(2): 158-161.
6. Jakobsen J, Christensen KS and Rasmussen OS Patellar fracture treatment. Orthop Scand., 1985; 56 : 430-432.
7. Edwards SB, Johnell O and Redlund-Johnell I Patell,a fractures– a 30 years follow-up. Acta Orthop.Scand. 1989 ; 60 : 712-714.
8. Shobat S, Mann G, Functional results after patellar fractures. Arch. Gerontol. Geriator. 2003; 37(1): 93-98.
9. Carpenter JE, Kasman R, Matthews LS. Fractures of the patella. Instr Course Lect. 1994;43:97–108
10. Carpenter JE, Kasman RA, Patel N, Lee ML, Goldstein SA., Biomechanical evaluation of current patella fracture fixation techniques. J Orthop Trauma. 1997;11:351–356.
11. Cramer KE, Moed BR. Patellar fractures: contemporary approach to treatment. J Am Acad Orthop Surg.1997;5:323–331.
12. Fortis AP, Milis Z, Kostopoulos V, Tsantzalis S, Kormas P, Tzinieris N, Boudouris T. Experimental investigation of the tension band in fractures of the patella. Injury. 2002;33:489–493.
13. Haxton HA, Functions of patella and effects ofits excision. Surgery Gynac. Obst. 1945 ; 80: 389-395.
14. Heineck AP, The modern operative treatment of fractures of the patella – an analytical review of over 1100 cases treated by operative methods. Surg. Gynaec. Obstet. 1909; 9: 177-248.
15. Instructional Course Lectures, AAOS fractures of Patella. J. Bone Joint Surg., 1993; 75A: 10-15.
16. Kaufer H, Mechanical functions of patella. JBJS. 1971; 53A : 1551-1552.
17. Kaufer H, Patella biomechanics. Clin. Orthop. ; 1979 : 144, 51-54.
18. Merchant AC, Mercer RL, Jacobsen RH and Cool CR, Roentenographic analysis of patellofemoral congruence. J. Bone Joint Surg. 1974 ; 56 : 1391-1396.
19. Benjamin J, Bried J, Dohm M, McMurtry M. Biomechanical evaluation of various forms of fixation of transverse patellar fractures. J Orthop Trauma. 1987;1:219–222.
20. Park MS, Chung CY, Lee KM, Lee SH and Choi IH, Which is the best method to determine the patellar height in children and adolescents? Clin. Orthopaedics & Related Res. 2010; 468(5): 1344-1351.

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Published

2015-08-31

How to Cite

Jabshetty, A. B. (2015). A Comparative Study Of Modified Tension Brand Wiring And Cannulated Cancellous Screw Fixation In Management Of Transverse Fractures Of Patella: A Comparative Study Of Modified Tension Brand Wiring And Cannulated Cancellous Screw Fixation. National Journal of Integrated Research in Medicine, 6(4), 1–5. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/928

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