A prospective observational study of 30 patients of avulsion fracture treated with tension band wiring followed up to 6 months

Abstract

Introduction: Wiring is the earliest forms of internal fixation. A loop of SS (Stainless steel- 316L) wire is passed around the fragments or through the drill holes and the ends are twisted together. It is used in Fractures of patella, olecranon and malleolus, greater trochanter of femur, greater tuberosity humerus, lateral end clavicle.In the present study, tension band wire technique was used which include use of 2 K wires and SS wire. The 2 K wires used, anchors to the TBW loop made by the SS wires and prevents tilting/rotation of fragments and holds the reduced fracture fragments in place till union.Aims and Objective: To study the technique of TBW and its principle as a modality of treatment. To clinically evaluate the results and efficacy of this principle and technique. We did prospective study of 30 patients of various fractures requiring K wire and TBW surgery for those fractures between October 2016 to October 2018.Results: We observed patella fracture is the most common constituting 33%, medial malleolus 30%, olecranon 17%, greater trochanter femur 7% and is followed by lateral one third clavicle, greater tubercle humerus, distal end ulna and non-union medial malleolus which is 3%. Superficial infection in 1(3.3%) case of medial malleolus fracture, joint stiffness in 3 (10%) cases (1 each of fracture patella, fracture olecranon, fracture bimalleolus), migration of K wire in 1(3.3%) case of fracture patella and osteoporosis in 1(3.3%) case of greater tuberosity humerus.Time for radiological union in weeks was 7.84, with 9 for fracture patella, 8 for medial malleolus, olecranon and distal end ulna, 6 for Greater Trochanter femur and 4 for lateral end clavicle and greater tuberosity humerus.Conclusion: TBW is a simple, inexpensive technique and effective means of fixing fracture based on biomechanical principle with minimum complication.