A Prospective Clinical Study of Patellar Fractures Treated by Modified Tension Band Wiring
[1]
Siddaram N. Patil , Mamata Medical College, Khammam, Andhra Pradesh, India.
[2]
Sankar Rao P , Mamata Medical College, Khammam, Andhra Pradesh, India.
Background and objectives: Patellar fractures are common and it constitutes about 1% of all skeletal injuries resulting from either direct or indirect trauma. The subcutaneous location of the patella makes it vulnerable to direct trauma Any improper and inadequate treatment would inevitably lead to a great deal of disability which would be most perceptibly felt in a country like India, where squatting is important activity in daily life. Objectives: The objectives of the study are: 1. The advantage of this method of fixation in patellar fractures; 2. The complications associated with this method of fixation. Methods: This prospective study is done in Department of Orthopaedics at Mamata General Hospital, Mamata Medical College, Khammam –AndhraPradesh, during the period from April 2011 to Aug2012. This study consists of 30 cases of displaced transverse fracture patella treated by modified tension band wiring. Results: In our series the range of age was between 14-72 years, the mean age was 42.05 years and the incidence was high in the age group of 41-50 years. 22 fractures were in men and 8 fractures were in females. 20 fractures were as a result of indirect mechanism and 10 cases were due to direct trauma to the patella as in Road traffic accident. 17 patients had fracture on the right side and 13 patients had fracture on the left side. Based on WEST’S Criteria our results were graded as excellent in 26 cases (86.6%), good in 3 cases (10%) and poor in 1 case (3.3%).Conclusion: Our study shows that modified tension band wiring is a definitive procedure in management of displaced transverse patellar fracture with least complications. This surgery of modified tension band wiring helps for early mobilization post-operatively which plays an important role in final out come
[1]
Malgaingne JF. “Fractures in Adults”. Rockwood Greans New York. LIPPINCOTT WILLIAMS & WILKINS. V Edition. 2001.
[2]
Thompson JEM, comminuted fractures of Patella JBJS (Am) 1935:17:431-436.
[3]
Brooker. R. “Treatment of fracture patella by excision” a study of morphology of function Br. J.surg 1936-37: 24:733.
[4]
Grooves. E. W Hey “A note on the extension apparatus of the knee joint” 1937: Br.J.Surg 24:747-748.
[5]
Haxton. H. A. “The functions of the patella and the effects of its excision” Surg gynae obstet 1945: 80:389.
[6]
Scott. J. C: “fractures of the patella” JBJS:1949: 31-Br:76.
[7]
E1nolas.S, A.J. Aho and P. Kallio. “Patellectomy after fracture” Acta. ortho Scand 1967:441-447.
[8]
Muller-M.E. et al. “Manual of internal fixation” Technique recommended by the AO-ASIF group 564-568.
[9]
Kaufer. H. “Mechanical functions of the patella” JBJS (Am) 1971:53:1551.
[10]
Weber. K. J., Janecki Cj. Me LEOD P. et al. “Efficacy of various forms of fixation of transverse fractures of the patella”. JBJS A 1980:62(2) March.
[11]
Dudani. B and Sanchet1 K.M “Management of fracture patellae by tension band wiring” Ind.J ortho 1981:15-1:43-48.
[12]
Liang, Quan and Wu. Jia Wen “Fracture of the patella treated by open reduction and external compressive skeletal fixation” JBJS (Am) 1987:69-A:83-89.
[13]
Marya S.K, Bhan S and Dave P.K “Comparative study of knee function after patellectomy and osteosynthesis with a tension band wiring following the patellar fracture” Int.Surg 1987:72(4) Oct-Dec.
[14]
Walter Braun Manfred, Axel, Klaus Kundel and Stephen “Indications and results of non-operative treatment of patellar fractures” Clinical ortho and related research 1993:289,197- 201.
[15]
A.K. Us and Kinik “Self locking modified tension band technique” Arch Orthop Trauma Surg 1999:119:432-434.
[16]
Gray’s Anatomy-Text book of Anatomy XXXVII Edition.
[17]
Thomas A Russel “Cambell’s Operative Orthopaedics” New York Mosby year Book Inc. 1992:841-847.
[18]
Scap1nelli.R. “Blood supply of human patella” JBJS (Br):1967:49:563-570.
[19]
Jame’s E. Carpenter et al. “Fractures of patella” JBJS 1993:75 A: 1550-1561.
[20]
Houghton. G. R. Ackroyd. C. E. “Sleeve fracture of the patella in children” JBJS 1979:61-B May 105-168.
[21]
Peoples. R. E. et al. “Function after patellectomy”. Clinical orthopaedics and related research. 1978:180-6, 132 May.
[22]
Charles H. EPPS “Complications in Orthopaedic Surgery” 1986:544-548.
[23]
Torchia ME, Lewallen DG, “open fractures of patella: J Ortho Trauma 1996:10:403-409.
[24]
Nummi J. Fracture of patella: “a clinical study of 707 patellar fractures”. Ann Chir Gynaecol Fenn 1971:179:1-85.
[25]
Bostrom. A. “Fractures of the patella” A study of 422 patellar fractures. Acta ortho scand 1972.
[26]
P.C. Leung and S.Y Lee “Percutaneous tension band wiring” A new method of internal fixation for mildly displaced patellar fracture. J. Ortho Trauma 1983 Vol 23 Jan 62-64.
[27]
Mehmet Vatansever, Fehmi Kuyurtar, Mufit sadiogler. Surgical management of patellar fractures. Acta Orthop trauma Turc: 1996:30(3):290-293.
[28]
Chang JH. Sohn JM, Bank WJ, Song JH. “Pattelar fractures treated by modified tension band wiring”. J. Korean fracture society 1993 Nov:6(2):262-270.
[29]
Phieffer, Laura.S MD; Kyle Richard F. MD, “Treatment of patellar fractures” Techniques in knee surgery, 2(3):153-159. Sept 2003.
[30]
Levack. B. Flannagak J.P and HOBBS: “Results of surgical treatment of patellar fractures” JBJS-1985: 67-B 416-419.
