Percutaneous Tension Band Wiring for Patellar Fractures

Abstract

purpose. To evaluate outcome of percutaneous tension band wiring for transverse fractures of the patella. Methods. 16 men and 7 women aged 27 to 65 (mean, 40) years underwent percutaneous tension band wiring for transverse fractures of the patella with a displacement of >3 mm. Pain, operating time, mobility, functional score, and complications were evaluated. results. 20 patients underwent successful percutaneous tension band wiring. The remaining 3 patients in whom closed reduction failed underwent open reduction and tension band wiring. The mean operating time was 46 (range, 28-62) minutes. The mean follow-up period was 20 (range, 15-30) months. At the latest follow-up, all patients had regained full extension. The objective score was excellent in 20 patients and good in 3, whereas the subjective score was excellent in 17, good in 5, and fair in one. All patients had radiological union at week 8. One 2012;20(2):166-9 patient had patellofemoral arthritis (secondary to a postoperative articular step). Two patients developed superficial infections, which resolved after antibiotic therapy. Mean thigh muscle wasting was 0.7 (range, 0.4-1) cm. Three patients encountered hardware problems (impingement/irritation of the skin over the knee) necessitating implant removal. conclusion. Percutaneous tension band wiring is a viable option for transverse fractures of the patella. Journal of Orthopaedic Surgery

Comparison of titanium cable tension band and nickel-titanium patella concentrator for patella fractures

“…An operator can control the degree of tightness to the maximum extent; this is especially important for osteoporotic patients. 17,18 Because of these advantages of a titanium cable, patellar fractures can be fixed more firmly without causing loosening, thus facilitating the early functional exercise of the knee joint.…”

A Novel Surgical Technique for Patellar Fracture: Application of Extra-articular Arthroscopy With Hanger-Lifting Procedure

“…2 Furthermore, the joint surface could not be Closed reduction has been reported by various authors previously. [3][4][5][6] All of these cases used fluoroscopy for the reduction. We have encountered some difficulty in correcting rotational displacement with this method because the shape of the patella cannot be projected using a 2-dimensional monitor.…”

“…[4][5][6] A transverse fracture is the best indication. Although this procedure may certainly be technically demanding and requires thorough assessment of the type of fracture before the procedure, we must have courage not to hesitate to convert to an open operation any time when encountering trouble during an operation.…”

“…Tension-band wiring and/or screw fixation can usually be performed without difficulty with these 4 small incisions as shown in previous reports. [3][4][5][6] Case Presentations…”

“…[1][2][3][4][5][6] Usually from a longitudinal or transverse incision, tension-band wiring and/or screw fixation is attempted as the gold standard. 2 Some procedures introduced subcutaneous wiring with small incisions using an image intensifier, [3][4][5][6] which is not always sufficiently accurate because the images are 2-dimensional. Other authors reported the use of percutaneous wiring with the aid of an arthroscope 5,6 as a means of confirming intra-articular inspection.…”