A study of functional and clinical outcome for augmentation plating with tension band wiring for complex patella fractures

Abstract

Background: Tension Band wiring is a standard age-old technique used for treating simple fracture patella. However comminuted fracture patella treated only with tension band wiring the results were not satisfying as the rigid and anatomical fragment fixation was not possible. Here we describe a newer method of using a low profile plate along with the standard tension band wiring for treating the comminuted fracture patella with the aim of getting anatomic and rigid fixation and good function. The purpose of this prospective study is to determine the effectiveness of this technique of augmentation plate with tension band wiring used in comminuted patella fracture and its effect on functional and clinical outcome. Methods: Between Jan 2015 and May 2019, 30 patients with displaced comminuted fracture of patella were included in the study. All the patients underwent fixation of fracture of patella with low profile plate and tension band wiring. The knee function of the patients and status of the patient were determined using Lysholm knee score and KOS score. Results: The average follow up period was 12 -15 months. At 12 months follow up bone healing was satisfying in all the patients and the average range of motion was 0-120 degree at the end of 12 months. Score Lysholm knee scale: The results were excellent in 21patients, good in 8 patients and 1 patient with rupture of ligamentum patellae had gradual (excellent) results. One patient had complication with ligamentum patellae rupture on subsequent fall at 8th month and required resurgery and repair for the same. Conclusions: The technique of augmentation plate is as effective and safe for treating complex comminuted fracture patella with excellent clinical outcome and results.