COMPARISION OF HORIZONTAL & VERTICAL FIGURE OF 8 TENSION BAND WIRING IN TRANSVERSE AND DISPLACED FRACTURE PATELLA

Dr. Dibyendu Biswas, Dr Avijit Basak

Abstract


INTRODUCTION : Fractures of the patella constitute almost 1% of all skeletal injuries, resulting from either
direct or indirect trauma. Patellar fractures are classified as- transverse, longitudinal, polar or comminuted).
However, 30 % of patella fractures require surgical intervention. Most commonly, tension band wiring utilizes two
K wires and a vertically or horizontally oriented Figure of 8 construct using Stainless steel wire.
AIMS : To compare the results of vertically oriented figure of 8 tension band wiring versus horizontally oriented
figure of 8 tension band wiring for displaced transverse fracture of patella in adults.
MATERIAL & METHODS : 32 patients coming at OPD & emergency of Department of Orthopaedics with
displaced transverse fracture patella with in age group of 18 – 60 years treated with Tension Band Wiring (TBW)-
Vertical & Horizontally orientation.
RESULTS: In our study, 32 adult patients with displaced transverse fracture of patella were randomly allocated
into two group i.e. Vertical group (treated with vertically oriented figure of 8 TBW) and Horizontal group
(treated with horizontally oriented figure of 8 TBW). Patients from both groups reported mild pain at two weeks. Pain,
which was subsided by 4 weeks. All fractures of both group united satisfactorily 4-5 weeks after surgery.
Maximum mean knee flexion for Vertical group at 4 weeks, 8 weeks and 12 weeks post operatively was 105
degrees, 134 degrees and 137 degrees respectively. Maximum mean knee flexion for Horizontal group at , 4
weeks, 8 weeks and 12 weeks post operatively was 115 degrees, 134 degrees and 136 degrees respectively.
Slippage of SS wire was a fairly common complication, occurring in 37.5 % in Vertical group and 25 % in
Horizontal group & the complications had no negative impact on knee ROM.
CONCLUSION : Transverse fracture of patella in adults is best treated by open reduction and internal fixation
using tension band wiring. Using a horizontal figure of 8 construct is theoretically superior to the more common
vertical figure of 8 construct achieving better inter-fragmentary compression. But our study reveals the clinical &
radiological outcomes of horizontal and vertical constructs to be almost identical.


Keywords


Tbw, Figure Of 8, Inter-fragmentary Compression

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References


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