TENSION BAND WIRING OF TRANSVERSE FRACTURE PATELLA: STILL STANDS PROUD IN AN ERA OF MULTIMODIAL MANAGEMENT TECHNIQUES
Abstract
Introduction: Patella is an important bone of the body with role in knee biomechanics as well as knee joint formation. Displaced fractures need to be reduced meticulously to reconstruct the joint. There are diverse patterns of fracture of patella and at the same time various fixation methods for a single fracture type. Many new techniques have emerged in recent times including screw and wire, plating, etc. Tension Band Wiring (TBW) is a time tested procedure with excellent results. We have conducted this study to further stress the importance of this technique in transverse fracture patella.
Objectives: To study functional outcomes of patients treated with TBW in terms of range of motion, quadriceps strength, time to union.
Study design: Prospective and retrospective observational study.
Material and methods: This was a prospective and retrospective hospital based study of patients with road traffic injuries presenting to Orthopaedic emergency department of Dayanand Medical College and Hospital, Ludhiana, India. Data was collected in a predesigned proforma including patient and injury details.
Results: Age group ranged from 22 to 77 years (mean 40.46 years). 73% (n=19) patients were males, similarly 73% (n=19) fractures were on right side. Majority (77%, n=20) were road accident victimsl. Out of 26 patients that were followed up, six patients had union evident by 10 weeks (n=6; 23.1%). The mean radiographic union time was 12.77 weeks. Twenty two out of twenty six of our patients had no pain (n=22; 84.6%), range of motion more than 90° and final quadriceps strength >75%.
Conclusion: TBW patella is a valuable procedure in transverse displaced fracture patella, is safe, quick and time tested technique with good functional outcomes and lesser complications. With the ready availability of simple instruments and implants, this is a universally gold standard technique for AO type C1 type of fractures of patella.
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