Locked tension band wiring using ring pins for patellar fractures: a method of minimising implant migration

Kim, Min Bom; Lee, Young Ho; Shin, Woo Cheol; Baek, Goo Hyun

doi:10.1007/s00402-014-2071-z

Cited by 19 publications

(16 citation statements)

References 18 publications

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“…Tension band constructs employ a variety of implants including Kirschner wires, malleable steel wires, cannulated screws, cables, or suture, with no implant or combination of implants proving to be superior to another. 5,9,[18][19][20][21][22][23] Partial patellectomy with advancement of the patellar tendon remains the most common treatment when there is significant comminution of the inferior pole. Currently, there is no well-established method to effectively treat comminuted fractures and those that involve the inferior pole.…”

Section: Discussionmentioning

confidence: 99%

Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

et al. 2018

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Treatment of patella fractures is fraught with complications and historically poor functional outcomes. A fixation method that allows for early mobilization and decreases symptomatic hardware rates will improve knee range of motion, postoperative functional status, and reoperation rates. The purpose of this study was to evaluate the functional outcomes after locked plate osteosynthesis of patella fractures at a Level 1 trauma center. A retrospective case series was conducted of patients who underwent open reduction internal fixation (ORIF) of a patella fracture using a locked mesh plating technique coupled with neutralization of forces on the distal pole of the patella. Twelve patients were evaluated at a mean follow-up of 19 months (range, 6-30) with physical exam, functional outcomes, and radiographs. There were 9 women and 3 men with an average age of 66.1 years (range, 53-75). Radiographic bony union was achieved in all patients by 3-month follow-up. Visual Analog Pain Score averaged 1.7 (median, 1.0; range, 0-8), the mean Knee Outcome Score - Activities of Daily Living Scale was 83.9 (median, 92.1; range, 45.7-100.0), the mean Short Form Musculoskeletal Function Assessment (SMFA) Function Index was 9.9 (median, 3.7; range, 0.7-41.2), and the mean SMFA Bother Index was 11.1 (median, 3.1; range, 0-62.5). The SF-36 Physical Component Score mean was 48.4 ± 8.5 and the SF-36 Mental Component Score mean was 54.1 ± 9.6. No complications developed and there were no reoperations for nonunion, infection, or symptomatic hardware. This study demonstrates that locked plate osteosynthesis for operative patella fractures can reliably achieve bony union with potentially superior functional outcomes as compared with traditional methods. Further studies are needed to evaluate plate fixation for patella fractures, but early results are promising.

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Section: Discussionmentioning

confidence: 99%

Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

et al. 2018

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“…[6]Recently, attention was paid to modify patellar tension band wiring to minimize implant migration with locked tension band wiring using ring pins. [7]The authors retrospectively reviewed 36 patients, with no fixation failure or pin migration. [7]Another treatment option is cannulated screw instead of k-wires.…”

Section: Discussionmentioning

confidence: 99%

“…[7]The authors retrospectively reviewed 36 patients, with no fixation failure or pin migration. [7]Another treatment option is cannulated screw instead of k-wires. [8] In our case, surgery was performed in another institution with a standard technique and complete healing of the fracture six months after surgery.…”

Section: Discussionmentioning

confidence: 99%

Severe iatrogenic knee arthrosis caused by a delayed intra-articular migration of a broken k-wire. A potential destroying complication of patella tension band wiring

Carbone

Arceri

Canero

et al. 2014

J Minim Invasive Orthop

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Citation: Carbone S, Arceri V, Canero G, Gumina S. Severe iatrogenic knee arthrosis caused by a delayed intraarticular migration of a broken k-wire. A potential destroying complication of patella tension band wiring. J Minim Invasive Orthop, 2014, 1(5): e5. doi:10.15383/jmio.5. Competing interests:The authors have declared that no competing interests exist. Abstract: Patella fractures are relatively common injuries. Tension band wiring is often used to treat displaced patella fracture. Wire breakage and migration is a well-known complication of using a wire tension band construct. Conflict of interest: NoneWe report a case of intra-articular migration of a broken k-wire used for patella tension band wiring two years after fixation and noted six months after the last radiological examination. The broken wire was removed arthroscopically and remaining hardware via three mini-incision of the skin. The knee joint developed severe iatrogenic arthrosis. We would like to show that broken hardware can migrate also into the joint and that it can rapidly cause severe knee arthrosis, a detrimental complication rarely described in literature. Implant removal at fracture healing or close clinical and radiological examination after internal fixation are mandatory to avoid such complication.

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“…This procedure has been described in previous reports. 7 Multifragmentary patella fractures were converted into simple transverse fractures using appropriate fixation methods and finally fixed with tension band wires. 8 The longitudinally released retinacular tissue was carefully closed.…”

Section: Surgical Techniquementioning

confidence: 99%

A Transpatellar Approach to Treat Distal Femoral Type C3 Fractures Combined with Patellar Fractures

et al. 2018

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We report our surgical method used to treat type C distal femur fractures accompanied by patella fractures whereby we approach the articular surface of the femur through the already-fractured patella. We treated 10 patients with type C3 distal femur and patella fractures between May 2013 and April 2015. Because the patella was fractured in all cases, we could approach the articular surface of the distal femur through the transverse gap between the retracted patellar fracture fragments, "transpatellar approach." Any surgical complications were recorded. Knee function was evaluated using the Böstman system. The average age of the 10 patients (8 males) was 42.9 years (range, 22.0-58.0 years). All distal femur fractures were type C3, combined with patella fractures. Bony union of the distal femur and patella was achieved in all but one patient, who required an additional bone graft (without any change in the implant). Overall, three patients (30%) reported excellent results and seven (70%) reported good results, based on the Böstman system. A midline anterior approach through a patella fracture adequately exposes the entire joint surface of the distal femur, except the posterior surface. This approach is useful when treating a type C distal femur fracture accompanied by a patella fracture. The level of evidence is IV.

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Locked tension band wiring using ring pins for patellar fractures: a method of minimising implant migration

Abstract: This implant could facilitate satisfactory fixation, restore the integrity of the extensor mechanism, and reduce the possibility of implant migration and implant-related discomfort.

Cited by 19 publications

References 18 publications

Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

Severe iatrogenic knee arthrosis caused by a delayed intra-articular migration of a broken k-wire. A potential destroying complication of patella tension band wiring

A Transpatellar Approach to Treat Distal Femoral Type C3 Fractures Combined with Patellar Fractures

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