Analysis of percutaneous tension band wiring for patellar fractures
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 1
Abstract
Aim: Patella fractures are more common and account for approximately 1% of all fractures1. The most common method of fixation is a modified tension band wiring by using 2 k wires through a midline longitudinal incision which has its own complications. We analyzed the outcome of percutaneous tension band wiring which has less complication rate than open tension band wiring. Materials and Methods: Our study was a prospective study conducted in Department of Orthopaedics, Coimbatore medical college during March 2015 to December-2016. We analyzed the clinical and radiological outcome of transverse patellar fractures in 20 patients treated with percutaneous tension band wiring. There were 14 men and 6 women aged 22 to 50 (mean 36 years) in our study. Pain, operating time, mobility, functional score, and complications were evaluated. Results: Operative time and blood loss in percutaneous tension band wiring is much less compared with open tension band wiring. This technique both clinically and radiologically showed rapid bony union. Lysholm knee score that was used in our study is more with percutaneous tension band wiring. Mean operating time was 30 (range 20 to 50) minutes. The mean follow up period was 8 months (range 6 to 12) months. At the latest follow-up, all patients had good results with painless knee motion, no quadriceps wasting and no subjective disability. Total range of motion was excellent at an average of 142.4 degrees of knee flexion. There were no complications like infection, limitation of knee motion, loss of reduction, implant breakage. All patients had radiological union at eight weeks. Conclusion: As the percutaneous tension band wiring is done without a wide skin incision, patient satisfaction is more. This technique provide stable fixation, allows early mobilization by minimizing injury to extensor mechanism and reduce cosmetic problem in scar. Hence we conclude percutaneous tension band wiring is a safe and alternative procedure to open tension band wiring
Authors and Affiliations
Dr. Kosalaraman Padmanaban, Dr. Balamurugan Palanisamy, Dr. Vivekanandhan Ramasamy, Dr. Vijay Krishnan Arcot Subramaniyan
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