A comparative study of tension band wiring and encirclage in treating transverse fractures of patella
DOI:
https://doi.org/10.18203/2349-2902.isj20171517Keywords:
Encirclage, Extensor mechanism, Fracture patella, Tension band wiringAbstract
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.References
Jabshetty AB. A comparative study of modified tension band wiring and cerclage wiring. Indian J Sci Tech. 2011;4(10):25-9.
Ong TK. A fixation of comminuted patellar fracture with combined cerclage and tension band wiring. Malaysian Orthopaedic J. 2008;2(2):15-7.
Marya SK, Bhan S, Dave PK. Comparative study of knee function after patellectomy and osteosynthesis with a tension band wiring following the patellar fracture. Int Surg. 1987;72(4).290-3.
Walter BM, Axel KK, Stephen Indications and results of non-operative treatment of patellar fractures. Clinical Ortho Rel Res. 1993;289:197-201.
Carpenter JE, Kasman R, Matthews LS. Fractures of patella. J Bone J Surg. 1993;75:1550-61.
Levack B, Flannagan JP, Hobbs S. Results of Surgical treatment of patellar fractures. J Bone J Surg. 1985; 67(3):416-9.
Srinivasulu K, Marya RS, Bhan S, Dave PK. Results of surgical treatment of patellar fractures. Ind J Orthop. 1986;20:158.
Leung PC, Lee SY. Percutaneous tension band wiring. A new method of internal fixation for mildly displaced patellar fracture. J Ortho Trauma. 1983;23:62-4.
Mehmet V, Fehmi KM. Surgical management of patellar fractures. Acta Ortho Trauma Turc. 1996;30(3):290-3.
Chang JH. Sohn JM, Bank WJ, Song JH. Pattelar fractures treated by modified tension band wiring. J Korean Fract Soc. 1993;6(2):262-70.
Phieffer, Laura S, Richard KF. Treatment of patellar fractures. Techniques in knee surgery. 2003;2(3):153-9.
Jakobson J, Christensen KS, Rasmussen S. Patellectomy-a 20 year Follow up. Acta Orthop Scand. 1985;56:430-2.
Bostman O, Kiviluoto O, Nirhamo J. Comminuted displaced fractures of the patella. Injury. 1981;13(3):196-202.
Peltier LF. Hector & Cameron. Fractures: A History and Iconography of their Treatment; 1977:1-332.
Srinivas K, Surya PR, Narendranath L, Prasad RV. Evaluation of results of surgical treatment of closed #s of the patella. Ind J Orthop. 1984;38:104-6.
Edwards SB, Johnell O, Redlund-Johnell. Patella fractures- A 30 years follow up-Acta Orthop Scand. 1989;42(4):441-7.
Depalma AF. Diseases of the knee. 3rd edn. Philadelphia. J. B. Lippincott; 1954:218.
