Modified Tension Band Research Articles

Is headless screw a valid alternative for the fixation of Chevron olecranon osteotomy? A biomechanical comparison of 4 fixation methods

BackgroundChevron osteotomy is a popular technique for repairing complex distal humerus intraarticular fractures. However, re-fixation presents challenges like hardware prominence and soft tissue damage. Headless cannulated screws are gaining popularity for fixation due to better bone purchase and less irritation. This study aims to compare different fixation strategies with headless screws for chevron osteotomy fixation. MethodsThis study utilized 32 polyurethane foam ulna specimens for biomechanical testing. The Chevron osteotomy was performed with an oscillating saw for all specimens. Four different techniques were used for re-fixation: modified tension band wire fixation, plate-screw fixation, cannulated screw fixation, and headless cannulated screw fixation. The constructs were mounted to the testing machine, simulating the elbow in 90 degrees of flexion. All specimens were tested under axial traction. Displacements at 350N and 500N and loads at the failure were recorded. ResultsAt the load of the implant failure, headless cannulated screw fixation revealed higher force values when compared to the other constructs, and modified tension band wire fixation showed lower force values compared to the other three groups (p < 0.001). The headless cannulated screw fixation group showed no significant differences in osteotomy displacements when tested to a 350N load. There were no significant differences in displacements at a 500N load between the four groups (p = 0.275). ConclusionThis study suggests that headless cannulated screw fixation is a viable and effective option for Chevron osteotomies. Headless cannulated screw fixation makes it a promising alternative to traditional fixation methods. This technique may be a more reliable fixation technique during daily activities and moderate elbow motions, indicating that it has the potential to succeed.

Evaluation of the functional result of early knee mobility in transverse patellar fractures treated with modified tension band wiring

Evaluation of the functional result of early knee mobility in transverse patellar fractures treated with modified tension band wiring

COMPARATIVE STUDY OF TENSION BAND WIRING, MODIFIED TENSION BAND WIRING AND FULLY THREADED CANNULATED CANCELLOUS SCREWS FOR FIXATION OF MEDIAL MALLEOLUS FRACTURES

Objective: To compare the three most commonly used fixation techniques: “Tension band wiring, modified tension band wiring, and fully threaded cannulated cancellous screws for fixation of medial malleolus fractures.” Methods: A prospective comparative cohort study was carried out at a tertiary care hospital in rural Maharashtra. Patients were allocated into three groups, with 33 patients in each group. The internal fixation was done by tension band wiring, modified tension band wiring, or fully threaded cannulated cancellous screws, depending on the group to which a patient belonged. Patients were assessed using the Baird and Jackson scoring system at each follow-up at immediate post-operative period, at 3, 6, 12, 24 weeks, and 1 year. For statistical purposes, p&lt;0.05 was considered statistically significant. Results: There was no significant difference in the three groups as regards age, body mass index, and mean time from injury to management. The most common mode of injury was road traffic accidents (51.52%), followed by falls from height (27.27%) and sports-related injuries (21.21%). The mean duration of surgery was significantly longer in cases managed by tension band wiring as compared to the other two groups. Implant-related complications were significantly less in the threaded cannulated cancellous screw group as compared to the other two groups. Overall excellent to good outcomes were observed in 97% of cases of cannulated cancellous screws as well as in modified tension band wiring and 84.8% of cases of tension band wiring, respectively. Conclusion: Fully threaded cannulated cancellous screws or modified tension band wiring should be used for the management of medial malleolar fractures while considering the functional outcome and complications associated with each and patient-related factors.

A Comparison of the Efficacy of Cannulated Screws against Modified Tension Band Wire in the Management of Slightly Displaced Fractures of the Patella: A Novel Technique.

The study aimed to compare the outcomes of Open Reduction and Cannulated Screw Fixation (ORCF) and Open Reduction and Tension Band Wire Fixation (ORTF) for treating minimally displaced patellar fractures, with the intention to discern the more efficacious surgical method in terms of various clinical and radiographic parameters. The research was a retrospective controlled trial encompassing 63 patients, culminating in a final data set of 52 patients with transverse patellar fractures with less than 8 mm of displacement. Patients were assessed postoperatively at three, six, and twelve months using measures such as the Lysholm score, Visual Analog Scale (VAS) for pain, and goniometry for active knee extensions and flexion. Statistical analyses were performed using SPSS version 22.0. Results indicated superior clinical outcomes for the ORCF group at twelve months post-treatment, with notable higher Lysholm scores and lower VAS scores for pain at three-, six-, and twelve-month intervals. The ORCF group also demonstrated improved flexion and range of motion, with an average fracture healing time of 2.65 months and significantly lower complication rates, compared to the ORTF group. The ORCF method, leveraging headless compression screws and cerclage wire fixation, emerges as a promising approach for managing minimally displaced transverse patellar fractures, potentially offering improved clinical results and patient satisfaction in comparison to the traditional ORTF method. Further expansive and diverse studies are warranted to substantiate these findings.

Novel screw-cable integrated system(SCIS) for minimally invasive treatment of patella transverse fractures: a finite element analysis

BackgroundThe most recommended method for treating transverse patella fractures is modified tension band wiring (MTBW). However, the optimal instrument for use with MTBW is still undetermined. Hence, we aimed to design a novel screw-cable integrated system (SCIS) and compare its biomechanical characteristics with Kirschner-wire, SCIS, and Cable-Pin systems in treating transverse patellar fracture.MethodsA finite-element (FE) model of transverse patella fracture was created. The fracture model was fixed with either K-wire, SCIS, or Cable-pin. Different tension force loading (400 N and 800 N), direction(0° and 45°), and screw or K-wire depth(5 mm and 10 mm) were set. The maximum displacement of the fragment and maximum gap opening were measured by using FE analysis.ResultsCompared with the K-wire and Cable-pin system, SCIS increased the stability of the fractured patella by reducing fragment displacement and gap opening. Under 400 N loading in the direction 45°, SCIS with screw placing at 5-mm depth reduced the maximum fragment displacement (0.43 mm) by 49.62% and 26%, respectively, compared with the K-wire (0.22 mm) and Cable-pin (0. 22 mm) group. Meanwhile, the gap opening in SCIS (0.05 mm) was reduced by 83% and 59.8% (0.05 to 0.18) compared with the K-wire (0.30 mm) and Cable-pin (0.18 mm) group.ConclusionSCIS demonstrated improved biomechanical stability for treating transverse patellar fractures compared to MTBW with Kirschner wire and the Cable-Pin system. Finite element analysis showed SCIS substantially reduced fracture fragment displacement and gap opening under various loading conditions.

Inter-fragmentary compression using cannulated cancellous screws augmented with modified tension band wiring in transverse patella fractures

The classical Kirschner wires and tension band wiring technique, described by the AO foundation, has been the most widely used method for transverse patella fractures. In this study, we have adopted what we perceive to be an improved technique, the cannulated cancellous screws with modified tension band wiring. 20 patients with transverse patella fractures were included in our prospective single-blinded randomized control study with a duration of 3 years. All patients were operated on with modified tension band wiring with a 4 mm cannulated cancellous screw. Functional evaluation was made using the Tegner lysholm knee scoring scale. Roentgenograms were taken in AP and Lateral views to look for signs of radiological union and interfragmentary gap. The post-operative interfragmentary gap between fracture fragments with 65% of patients having a 0 mm gap, 25% of patients having a 1 mm gap, 5% of patients having a 2 mm gap, and 5% of patients having a 3 mm gap. The mean duration for the radiological union was 10 weeks. Mean Tegner lysholm score at 6 months was 88±4.7. We concluded that modified tension band wiring with cannulated cancellous screw is a safe, reliable, and better alternative method of fixation for transverse patella fractures with excellent union rate, range of motion, and functional outcome.

Figure of eight suturing technique with fiber wire for patella fracture: a novel approach

Modified tension band wiring (TBW) is the most commonly used technique for the management of patella fractures. However, all patella fractures are not-amenable to TBW. Tension band wiring, inter-fragmentary screw fixation, and the combination of cerclage wiring and screw fixation are used for internal fixation of these fractures. Surgical treatment is recommended for fractures that either disrupt the extensor mechanism or have greater than 2 to 3 mm of step-off and greater than 1 to 4 mm of displacement. In this series, we present ten cases managed with open reduction and internal fixation with figure of eight suturing technique using fiber wire. This series included ten patients with fractured patella and managed with open reduction and internal fixation with Tension band wiring with fiber wire. Patient demographics, fracture type, time to union, functional outcome, and complications were recorded. Patients were followed up for minimum of 6 months. All fractures went on to unite with average fracture healing time of 13.8 weeks. Mean Lysholm score and Bostman score were 85 and 27 respectively. Nine patients had excellent to good outcomes. One patient had poor outcome because of knee stiffness. Open reduction and internal fixation with figure of eight suturing technique using fiber wire are an efficient method for the management of severely comminuted and multi-fragmentary patella fractures with minimum complications.

Anterior hook plating of patella fractures: A biomechanical analysis and clinical series.

Compare anterior hook plating to established fixation constructs biomechanically and report outcomes and complications in a cohort of patella fractures treated with the technique. Lab based biomechanical study and clinical multicenter retrospective cohort study. Two US level one trauma centers.Patients/Participants: 51 patients (28M, 23F) with 30 simple transverse and 21 comminuted patella fractures. 36 cadaveric patellae for the biomechanical study. Biomechanical- Compared dorsal plating with cerclage wiring and modified tension band cable fixation in a comminuted patella fracture model in 36 cadaveric patellae. Constructs were tested in 0° and 45° of flexion. Clinical - We reviewed a consecutive series of patella fractures in two centers for outcome and complications. Biomechanical - construct stiffness. Clinical - reduction, union, complications, range of motion. Stiffness greatest in dorsal plating in both 0° and 45°. Dorsal plating (976 N, 1643 N) > modified tension band (317, 297) > cerclage (89.8, 150.3). 51 patients with patella fractures fixed with dorsal 2.7 mm mini-fragment plates including a distal to proximal lag screw through the plate from the nose of the patella. 9 Cases were small distal fragments not easily managed with screws and cables. All patients were followed to union. There were 2 infections (1 superficial, 1 deep with nonunion) and 5 had hardware removal (9.8%). Dorsal plating is biomechanically and clinically superior to modified tension band and cerclage techniques in comminuted patella fractures. This method allows for fixation of small distal pole fractures.

Biomechanical evaluation of three fixation methods in a feline transverse patella fracture model.

This study aimed to compare the biomechanical properties of three stabilisation techniques in feline patella transverse fractures and select the strongest method with potentially minimal complications. Patella fracture was simulated in 27 feline cadaveric pelvic limbs (mean weight of the cadavers 3.78 kg), and the limbs were randomly grouped to be stabilised with one of the three stabilisation methods. The modified tension band wiring technique with a single Kirschner wire (0.9 mm) and figure-of-eight wiring (20 G) was applied to group 1 (n = 9). Group 2 (n = 9) was stabilised with a combination of circumferential and figure-of-eight wiring techniques with orthopaedic wire (20 G). Group 3 (n = 9) was stabilised with the same technique as group 2, but with #2 FiberWire. The knee joints were positioned and fixed in the neutral standing angle (135°) and tested by applying tensile force. The loads at gap formations of 1, 2 and 3 mm were recorded, and the maximum failure load was measured in each group. In all the loads at displacement (1, 2 and 3 mm), group 3 was significantly stronger than groups 1 and 2, respectively (P <0.017). Group 3 (261.0 ± 52.8 N) showed significantly stronger fixation in the maximum load compared with group 1 (172.9 ± 45.6 N) (P <0.017). No significant difference was observed between groups 1 and 2 (204.9 ± 68.4 N) or between groups 2 and 3. This study shows that the combination of circumferential and figure-of-eight techniques with FiberWire is more resistant to displacement than metal wire in this ex vivo feline patella fracture model.

Modified tension band wiring technique by safely inserting K-wires in olecranon fracture osteosynthesis

The present study presents the results of a modified tension band technique by surgically inserting K-wires to treat olecranon fractures. The modification includes inserting the K-wires from the olecranon's upper tip and directing them to the ulna's dorsal surface. Twelve patients (three males and nine females) from 35 to 87 years of age were operated for olecranon fracture. After the standard approach, the olecranon was reduced and fixed with two K-wires from the tip to the dorsal ulnar cortex. Then the standard tension band technique was carried out. The average operating time was 17.25±3.08min. No image intensifier was used since the wires' discharge was either visible, penetrating the dorsal cortex, or palpable through this area's skin. The time needed for the bone union was six weeks. In one female patient, the wires were cut out. This patient showed a satisfactory painless range of motion (ROM) of the elbow but did not achieve full ROM. However, this particular patient had a previous removal of the radial head, and she spent some time in the ICU intubated. The modified technique used here is as stable as the classic operation, and it is safe since there is no risk of injuring the nerves and vessels of the olecranon fossa. There is less or no need for an image intensifier. The outcomes of the present study are entirely satisfactory. However, many patients and randomized studies are needed to establish this modified tension band wiring technique.

Modified tension band wiring of transverse patella fractures through cannulated cancellous screws: An analysis of functional outcomes and complications

Introduction: The management of transverse patella fractures with modified tension band wiring using Kirschner wires, though routinely used is associated with complications such as implant loosening, wire migration, and infection. We hypothesized that using cannulated cancellous screws with tension band wiring through the screws will overcome these complications. Objective: The objective was to assess the functional and radiological outcomes following patellar fracture fixation with modified tension band wiring through cannulated cancellous screws. Materials and Methods: Twenty-four patients with transverse patella fractures fixed with modified tension band wiring through cannulated cancellous screws were included in this retrospective study. Surgical technique involved a vertical incision over the knee, reduction of the fracture initial fixation with Kirschner wires, replaced with cannulated cancellous screws. A stainless steel wire was passed through the lumen of the screws, and tension band was applied. Follow-up at 3, 6, and 12 months was done to assess the radiological union. Functional outcome was assessed with the Bostman scoring. Results: The study included 13 male and 11 female patients with an average age of 39.6 years, with 8 three-part and 16 two-part fractures. The average follow-up was 14 months, and the average time to union was 8.5 weeks. Twelve patients had an excellent, 11 patients a good, and one patient an unsatisfactory functional outcome as per the Bostman score. No infection or implant loosening was observed. Conclusion: The technique of patella fracture fixation with modified tension band through cannulated cancellous screws offers an enhanced stability, minimizing the complications such as implant migration, prominent implant, and refracture. As such, we recommend this technique in all transverse patella fractures.

Comparison of The Two Different Patella Fracture Fixation Technique: Finite Element Analysis

Introduction: Fractures of patella account for 1% of bone fractures and this type of injuries can lead to severe knee funciton restrictions due to its role in extansor mechanism. The most common type of fracture pattern is transverse or comminute. According to the guidelines, the most often used surgical techniques are modified tension band wiring and circumferential cercle wiring. However there is no clear information about the configuration of cerclage wiring in the tension band technique. For this purpose, a transverse fracture line was created in the patella finite element model and biomechanical comparison was made in both figure of eight and zero configurations&#x0D; Material and Method: A transverse fracture line was created in patella and the k-wires were directed proximally at 90 degrees in coronal plane, perpendicular to the fracture line. A cerclage wire was wound on each finite element model in figure of zero (reference 1 model) and figure of eight (reference 2 model) configurations. These models were compared with each other in finite element model, with the knee at a 45 degree flexion angle and applying 200 Nm, 400 Nm and 800 Nm of force.&#x0D; Results: When the opening amounts of reference 1 and 2 models were evaluated under 200 Nm, 400 Nm, and 800 Nm loads, it was found that there were 14%, 8%, 13% less openings in the reference 1 model, respectively. When the amount of pressure in the fracture line was evaluated under the same loads, the average pressure was 10%, 15% and 12% higher in the reference 1 model compared to the reference 2 model, respectively.&#x0D; Conclusion: When the determined parameters were evaluated, although the amount of opening at the fracture line was better in the reference 1 model, there was no significant difference between the parameters in both models. Both fixation types allow early motion in clinical applications and help the prevention of displacement of the fracture.

Understanding the Basic Principles and Biomechanics of Patellar Modified Tension Band Wiring Surgery: Are we on a Monotonous Path for Fixing Transverse Patellar Fractures?

Understanding the Basic Principles and Biomechanics of Patellar Modified Tension Band Wiring Surgery: Are we on a Monotonous Path for Fixing Transverse Patellar Fractures?

Loop Anchor Tension Band Fixation for Olecranon Fractures and Chevron Olecranon Osteotomy.

Although tension band wiring is effective for treating olecranon fractures, it is associated with a high reoperation rate because of hardware-related problems. The loop anchor tension band technique is a novel modification of the Arbeitsgemeinschaft für Osteosynthesefragen (AO)-modified tension band wiring technique. This technique is suitable for treating olecranon fractures without severe comminution and olecranon osteotomy. In the current case series, 2 intramedullary 1.25-mm Kirschner wires (K wires) were inserted as temporary fixation into the ulnar shaft from the olecranon after anatomical reduction. The proximal end of each K-wire was bent into a loop shape and advanced deep into the triceps tendon. A transverse hole was drilled distal to the fracture site, and a 1.0-mm metal wire was passed through the bone tunnel and the loops. The wire was tightened to form a figure-of-eight tension band construct. In total, 10 patients with a mean age of 49 (range: 19 to 85) years were included in this pilot series. The mean and minimum follow-up periods were 13.9 and 12 months, respectively. All fractures achieved favorable union, both radiographically and clinically. The mean QuickDASH score was 15.4 (range: 13.6 to 18.2) and the mean Mayo elbow performance score was 94 (range: 85 to 100). None of the patients experienced K-wire migration. The loop anchor tension band technique is a simple, cost effective modification of conventional tension band wiring and exhibited no implant migration in a pilot series.

Early Complications of Modified Tension-Band Wiring (MTBW) in the Treatment of Close Patellar Fractures

Introduction: Patella fracture account for 1 Percent of all skeletal fracture, Patella fractures are problematic because the loss of the extensor mechanism of the knee, loss of articular congruity and stiffness of the knee joint. The surgical goals are anatomic reconstruction of the articular surface and stable fixation to allow early motion. Modified tension band wiring MTBW (MTBW) is the procedure of choice for patellar fracture these days because of the dramatic decrease in post-operative complications with this procedure.The complications noted in the early post-operative period are infection,loss of reduction, prominence of hardware, and knee stiffness. Objective: To determine the frequency of early post-operative complications following modified tension band wiring MTBW for closed patellar fractures. Methods: This study was conducted in the department of orthopedic surgery, Lady Reading Hospital, Peshawar from June 2010-september 2011. Through a descriptive cross sectional study, a total of hundred patients of closed patellar fractures were selected in a consecutive manner from the OPD and ER department. All patients were subjected to modified tension band wiring MTBW under G/A by an expert orthopedic surgeon and data was also collected at 1st week, 1st month, 3 months and 6 months regarding early post-operative complications like loss of reduction, infection, prominence of hardware and stiffness. Results: Total patients were hundred. There were 60 (60 Percent) males and 40 (40 Percent) were females. Mean age of the patients was 43.82 years + 14.3SD years (range 20-85 years). 74 (74 Percent) were presented with history of road traffic accident. Overall complication rate by the end of 6 months was a total of 25 Percent with of 21 Percent patients with infection, 11 Percent had developed stiffness, 6 Percent with hardware prominence and only 4 Percent with loss of reduction. Conclusion: The frequency of early post-operative complication following modified tension band wiring MTBW for closed patellar fractures was higher than previously reported and further research work should be carried out to identify the factors responsible for it. Keywords: Developed Stiffness, Closed Fracture Patella, Modified Tension Band Wiring MTBW, Early Post-Operative Complications, Hardware Prominence,

Does pin configuration matter in modified tension band wiring for transverse patellar fracture? A biomechanical study

BackgroundModified tension band wiring has been widely used for the treatment of transverse patellar fractures. The optimal position of a Kirschner wire (K-wire) in modified tension band wiring, however, has not yet been determined. The purpose of the present study was to evaluate biomechanically the effect of K-wire position in a modified tension band wiring technique. MethodsForty-two polyurethane foam patellae with a midway transverse fracture were assigned to six different fixation groups regarding different pin configurations in tension band wiring. The depth or sagittal position of the K-wire was divided into anterior and posterior. The coronal position of the K-wire was divided into central, medial and lateral. A specially designed set up simulated a knee with 60° flexion. All specimens were tested under axial traction. Loads at 2 mm and 4 mm fracture displacement and at the failure of the construct were recorded. ResultsAt 2 mm fracture displacement, anterolateral (AL) placement of K-wires revealed significantly less durability when compared with five other groups (P < 0.001). At 4 mm fracture displacement, the AL group also revealed inferior biomechanical strength when compared with other groups. Posteromedial (PM) K-wire placement group revealed more durability when compared with the posterolateral (PL) group (P < 0.05). At failure of the osteosynthesis, anteromedial (AM) and anterocentral (AC) groups revealed superior biomechanical strengths (P < 0.05). ConclusionsThe coronal and sagittal position of K-wire affects the biomechanical characteristics of modified tension band wiring. Anterolateral placement of K-wires revealed inferior strength to all other constructs in modified anterior tension band wiring.

A Novel Technique for the Treatment of Inferior Pole Fractures of the Patella: A Preliminary Report.

Most inferior pole fractures of the patella are comminuted. Therefore, an ideal treatment method has not been determined. We have presented a modified tension band fixation technique-the Krachow suturing, Nice knot combined with tension band fixation-and reported the results of the procedure. A total of 16 inferior patellar pole fractures were treated at our institution between January 2019 and October 2020, 15 of which underwent treatment with the modified tension band fixation technique consisting of Krachow suturing with Nice knots combined with tension band fixation. The primary measures: knee motion, Bostman score, anterior knee pain, fixation failure. Bone union occurred at a mean of 9 weeks postoperatively (range: 8-13). There were no cases of postoperative anterior knee pain, refracture of the inferior patellar pole or wire breakage. The patients regained full ROM of the knee joint without functional deficits during follow-up; the mean ROM was 128.46° ± 7.07° (range: 113.4°-137.8°). At the last follow-up, all patients had a mean Bostman score of 28.40 ± 1.29 (range: 26-30), with an excellent score in 11 patients and a good score in four patients. The modified tension band fixation technique for the treatment of inferior patellar pole fractures is a simple and easy-to-perform surgical technique that provides stable fixation and good functional results.

Evaluation of Internal Fixation of Patellar Fractures Using Cannulated Screws with Tension Band versus Modified Tension Band Wiring

Evaluation of Internal Fixation of Patellar Fractures Using Cannulated Screws with Tension Band versus Modified Tension Band Wiring

A New Antirotation Strategy of K-Wire Tension Band Therapy for Patellar Fracture.

BackgroundPatellar fracture is a common phenomenon observed in orthopedic clinics. Many methods have been shown to be effective in the fixation of patellar fracture. However, there are few studies on the antirotation effect of these methods. The purpose of this study is to present a new strategy of K-wire tension band therapy for patellar fracture and explore the antirotation effect of the modified tension band method on patellar fracture.MethodsA retrospective clinical observation study was conducted on 75 patients with patellar fracture. Totally, 46 patients were enrolled to the traditional group, who received the traditional K-wire tension band therapy. The modified group included 29 patients on whom our new strategy was implemented. The operation time, intraoperative blood loss, and fracture healing time were collected to compare the two operations and the knee society score (KSS) scores after the operations, and complications were recorded and retrieved to indicate the effectiveness of the two treatments.ResultsThe preoperative baseline data (gender, age, fracture types) of the two groups showed no significant statistical difference. Similarly, there was no significant difference in the operation time, intraoperative blood loss, and fracture healing time between the two groups. The KSS clinical scores 1 year after operation was 90 (84, 95) for the traditional group as compared with 99 (97, 100) for the modified group (p < 0.05). The KSS functional scores 1 year after operation in the two groups were 90 (65, 90) and 100 (90, 100) (p < 0.05). The incidences of complications due to the rotation of K-wires in the traditional group and the modified group were 76.1% (35 of 46) and 6.9% (2 of 29) with a significant statistical difference (p < 0.05).ConclusionThis study shows that our modified tension band therapy is an effective strategy for antirotation in the treatment of patellar fracture and proves that it can achieve better clinical outcomes than the traditional K-wire tension band method. This new strategy may be a safe and effective clinical technique for the treatment of patellar fracture. However, more prospective randomized controlled trials with larger sample sizes are still needed to further prove its efficacy.

Modified Tension band wiring vs Tension band with cannulated cancellous screws in treating transverse patellar fractures

Purpose: Despite being the most favoured modality of treatment in patellar fractures, modified tension band wiring (MTBW) technique has serious demerits with regards to clinical outcomes. Tension band with cannulated cancellous screws (TBCC) is a recent technique to overcome the demerits associated with former technique. This study was aimed to compare these two techniques, in terms of clinical outcomes, in treating patellar fractures. Methods: This hospital based prospective randomized study was conducted in a tertiary care hospital for 2 years. Thirty patients with Gustillo-Anderson grade 1 and 2 compound fractures were randomly divided into two treatment groups, viz MTBW and TBCC groups. After performing pre-operative investigations, patients were anesthetized, and knee was operated by the standard procedures. Post-surgery, radiographs were taken and range of motion, pain score (Visual Analogue Scale (VAS)), time taken for radiological union, clinical outcomes were recorded. Results: Mean age of the patients included in the MTBW and TBCC group were 53 years and 58.5 years, respectively. Between the groups, range of motion, IOWA score assessed at the end of 6 months, did not vary significantly (P&gt;0.05). Meanwhile, the difference noticed with average time taken for radiological union was also nonsignificant (MTBW =11 weeks. TBCC=10 weeks).