A comparative study of modified tension brand wiring and cerclage wiring in management of transverse fractures of patella

Abstract

Management of patellar fractures is controversial. This study compares the results of two commonly used methods of internal fixation for transverse fractures of patella namely cerclage wiring and modified tension band wiring. Outcome of treatment of twenty (20) cases of transverse fractures of patella from the 2 hospitals attached to the MRMC Medical college, Gulbarga, India were studied between March 2003 to February 2005. Group -A consist of 10 cases which were treated with modified tension band wiring and group-B consist of 10 cases treated with cerclage wiring. Union was achieved in all 20 cases results were compared by using modified Bostman scale. Nine out of 10 patients treated with modified tension band (Group-A) has excellent to good results, 7 patients had knee flexion more than 120°, 8 patients had near normal quadriceps power and 1 patient had extensor lag. In group-B which were treated with cerclage 8 out of 10 patients had excellent to good results, 6 of them had knee flexion of more than 120°, 7 of them had near normal quadriceps power and 2 of them developed extensor lag. Out of 20 cases, 3 cases were compound Grade-I. All 3 cases healed satisfactory, one developed infection leading to stiffness. The results were comparable to closed group. Quadriceps wasting were seen in all 20 cases but it was minimal in group-A treated with modified tension band wiring may because of shorter period of immobilization. It was found that the results of all the cases were comparable but cases treated with modified tension band wiring showed better results as compared to cerclage wiring as the stability of implant is better and post operative rehabilitation is faster. Compound grade-I fractures of patella shows good results when treated by internal fixation.