Modified Tension Band Wiring Research Articles

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

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.

Surgical results of 5th metatarsal stress fracture using modified tension band wiring

The purpose of this study was to evaluate the surgical results of modified tension band wiring using two cortical screws for the treatment of fifth metatarsal stress fractures. Forty-two patients with Torg's type I and II fifth metatarsal stress fractures treated using the modified tension band wiring technique from 2005 to 2008 were evaluated retrospectively. All of the patients were elite athletes. The mean length of follow-up was 26±16months (12-62months). All patients were able to return to their previous levels of sporting activity. The mean time to union as determined by CT was 75±25days (40-150days). However, during follow-up, there were 4 delayed unions, 1 nonunion, and 4 refractures. The described modified tension band wiring technique is a good alternative method for the surgical treatment of Torg's type I and II fifth metatarsal stress fractures. Case series with no comparison group, retrospective case series, Level IV.

Patellafrakturen

Fractures of the patella account for approximately 0.5% to 1.5% of all skeletal injuries. The diagnosis is made by means of the mechanism of injury, physical and radiological findings. The kind of treatment of patella fractures depends on the type of fracture, the size of the fragments, the integrity of the extensor mechanism and the congruity of the articular surface. Independent of the kind of treatment an early rehabilitation is recommended. Modified tension band wiring is the most commonly used surgical treatment for patella fractures and can be used for almost every type of fracture. Due the superior stability in biomechanical studies two parallel cannulated lag screws combined with a tension band wiring are the treatment of choice for horizontally displaced two-part fractures. In comminuted fractures a partial or total patellectomy may be necessary. However, since the loss of quadriceps muscle power and the poor outcome total patellectomy should be considered as a salvage procedure.

The Treatment of Patellar Fracture with Modified Tension Band Wiring, using Cannulated Screws

The Treatment of Patellar Fracture with Modified Tension Band Wiring, using Cannulated Screws

EVOLUTION OF THE INTERNAL FIXATION OF LONG BONE FRACTURES

EVOLUTION OF THE INTERNAL FIXATION OF LONG BONE FRACTURES

Operative Treatment of patellar Fractures

We studied 45 patients of patella fracture who were treated by surgical method from March 1990 to December 1997. The results were analysed to evaluate the functional results of the knee according to methods of fixation and severity of comminution. The results were as follows. 1. Out of 45 cases, 11 cases were treated by tension band wiring, 19 cases by modified tension band wiring, 5 cases by tension band wiring by circumferential wiring, 8 cases by circumferential wiring, and 2 cases by screw fixation. 2. The mean fracture healing period was 6.9 weeks in cases of tension band wiring, 6.5 weeks in cases of modified tension band wiring, 6.2 weeks in cases of tension band wiring with circumferential wiring, and 7.3 weeks in cases of circumferential wiring. 3. The most favorable result was obtained in cases which were fixed with tension band wiring and circumferential wiring. 4. Modified tension band wiring seems to be a good method for displaced transverse fracture

Treatment of patellar Fractures with Modified Tension Band Wiring

Treatment of patellar Fractures with Modified Tension Band Wiring

Availability of Supplementary Circumferential Wire Loop in Treatment of Complicated Patellar Fracture

We have treated 22 patients of complicated patellar fracture with generally proposed fixation methods and supplementary circumferential wire loop as a checkrein or load sharing cable from Mar. 1995 to Feb. 1997 and then compared its surgical results with 15 patients of patellar fracture treated with modified tension band wiring alone in terms of functional recovery of the injured knee. The pattern of fracture was mostly comminuted(Bostman Type II), usually accompanying ipsilateral fractures with or without open wound, ligamentous injuries, or others. Although obtainning more satisfactory functional results in supplementary circumferential wire loop (68%) than control group(46.6%) in according to Lysholm and Gillquist scoring system and statistically significant difference in duration of regaining the functional arc of knee motion between two groups(p=0.007, Wilcoxon rank sum test) at 6 months postoperatively, we have found similar clinical results in two groups at 12 months follow-up(82% vs 80% in good results). Nevertheless, we thought that supplementary circumferential wire loop is one of the effective 대한골절학회지 제11권, 제4호, 1 9 98년 1 0월 The Journal of the Korean Society of Fractures Vol.11, No.4, October, 1998

Modified tension band wiring and Circumferential wiring in the operative treatment of patella fracture

Modified tension band wiring and Circumferential wiring in the operative treatment of patella fracture

Tension band wiring and Modified tension band wiring in the Operative Treatment of Patella Fracture

Tension band wiring and Modified tension band wiring in the Operative Treatment of Patella Fracture

Fracture Patella - Outcome of Early Movement of Knee After Stable Fixation

The study was carried out at Combined Military Hospitals of Jessore and Dhaka over a period of three and half years. The aim of this study was to evaluate the functional status of the knee joint by allowing early knee movement after stable fixation of fracture patella in 18 patients. The commonest age group involved in fracture patella was at the fourth and fifth decade (66.66 %). Road traffic accident (RTA) and domestic injuries like fall in the slippery ground were the major causes of fracture and the incidences were similar (44.44%). Stable fixation was achieved by applying modified tension band wiring in 7 patients but remaining 11 patients required additional cerclage wiring. Postoperatively (within 48 to 72 hours) when the pain was tolerable, assisted active movement of the knee was started. Subsequently assisted active, active and passive movement of knee along with quadriceps exercise was continued. The functional status of the knee was assessed according to a predecided subjective and objective evaluation chart. 13 patients (72.23%) found satisfactory (Excellent and good) in subjective evaluation and 16 (88.89%) in objective evaluation. One patient who did not follow the post operative advice adequately, developed more than 2 mm displacement at the fracture site and about 25° extension lag. It has been revealed that initiating early postoperative knee movement after stable fixation of fracture patella could prevent stiffness of knee and thereby confers better function. Key Words: Fracture patella, Early movement, Stable fixation. doi: 10.3329/jafmc.v5i1.2843 JAFMC Bangladesh. Vol 5, No 1 (June) 2009 pp.11-13