J Korean Fract Soc.  2014 Jul;27(3):206-212. 10.12671/jkfs.2014.27.3.206.

Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture

Affiliations
  • 1Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. chungkjmd@dreamwiz.com

Abstract

PURPOSE
The purpose of this study is to evaluate the results of tension band wiring and additional circumferential wiring in treatment of comminuted patella fractures.
MATERIALS AND METHODS
A retrospective study of 67 patients with follow-up period longer than six months who underwent tension band wiring and additional circumferential wiring for comminuted patellar fracture from January 2004 to December 2012 was conducted. Analysis was based on radiological evaluation of bony union and articular surface displacement, and clinically by evaluating the postoperative function of the knee joint using the Levack scoring system.
RESULTS
Only one case out of 67 (1.5%) showed nonunion without metal breakage while good bone union was achieved in all other cases. Excluding the nonunion case, range of motion was 90 degrees minimum, 135 maximum, 129 on average. Average displacement was less than 2 mm, and 64 out of 67 cases showed satisfactory outcome with excellent functional score according to the Levack scoring system.
CONCLUSION
Tension band wiring and additional circumferential wiring technique for treatment of comminuted patella fractures can be considered as an effective treatment for achievement of good bone union and restoration of normal knee function.

Keyword

Patella; Comminuted fractures; Tension band wiring; Cerclage wiring

MeSH Terms

Follow-Up Studies
Fractures, Comminuted
Humans
Knee
Knee Joint
Patella*
Range of Motion, Articular
Retrospective Studies

Figure

  • Fig. 1 (A) Preoperative radiographs of a 37-year-old male patient show comminuted and displaced fracture of patella. (B) Postoperative radiographs show well reduced bony fragments by tension band wiring and additional circumferential wiring.

  • Fig. 2 (A) Preoperative radiographs of a 43-year-old man show a comminuted patella fracture by a fall from a standing height. (B) Immediate postoperative radiographs show that the fragments are well stabilized by tension band wiring and additional circumferential wiring. (C) Loss of reduction was observed at four months after surgery. (D) Reoperation was performed using the same technique and good reduction of the fragments was achieved.


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