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

Authors

  • Sachin M. Khemkar Department of Orthopaedics, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India
  • Eknath D. Pawar Department of Orthopaedics, Grant Government Medical College and Sir JJ Group of Hospitals Mumbai, Maharashtra, India
  • Sandeep V. Gavhale Department of Orthopaedics, Grant Government Medical College and Sir JJ Group of Hospitals Mumbai, Maharashtra, India
  • Mrinal M. Kambli Department of Orthopaedics, Grant Government Medical College and Sir JJ Group of Hospitals Mumbai, Maharashtra, India
  • Vivek Chavan Department of Orthopaedics, Grant Government Medical College and Sir JJ Group of Hospitals Mumbai, Maharashtra, India
  • Nihar Modi Department of Orthopaedics, Grant Government Medical College and Sir JJ Group of Hospitals Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20233274

Keywords:

Transverse patella fractures, Tension band wiring, Cannulated cancellous screw, Tegner lysholm score

Abstract

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.

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Published

2023-10-26