Treatment of Patella Fractures

Henrichsen, Jacob L.; Wilhem, Spencer K; Siljander, Matthew P.; Kalma, Jeremy J.; Karadsheh, Mark S.

doi:10.3928/01477447-20181010-08

Cited by 56 publications

(59 citation statements)

References 84 publications

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“…Although there are new techniques such as cannulated screw tension band [11,12] system [13] and patella plate [14], the MTBW is still the most widely accepted surgical method for the treatment of patellar transverse fracture [7]. The MTBW technique is easy to operate on and economical to reduce the burden on patients, and the key of MTBW technique is to keep two k-wires parallel [8,15].…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, the technique of modi ed tension band wires (MTBW) has been the most commonly used surgical procedure and is considered the gold standard for transverse patella fracture [4][5][6][7]. This technique consists of two parallel K-wires perpendicular to the fracture line and a 8-shaped wire passing anteriorly over the patella and behind the K-wires.…”

Section: Introductionmentioning

confidence: 99%

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A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application

Wang

Xiong

Long

et al. 2020

Preprint

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Abstract Background Traditionally, the technique of modified tension band wires (MTBW) has been the most commonly used surgical procedure. The purpose of this study is to design a precise navigation device that can obtain a standard position of K-wires for (MTBW), and to compare the precise MTBW (P-MTBW) by a navigation device with the conventional MTBW (C-MTBW) by hands in a retrospective study.Methods The device is designed by solidworks2012 software (USA), which can provide a precise guidance for obtaining a parallel K-wires. In addition, it can set the distance between two k-wires and the level of k-wires below patellar anterior surface. From June 2014 to August 2018, a total of 112 patients are employed in this retrospective study. The patients are divided into P-MTBW group and C-MTBW group according to the surgical technique with or without the precise navigation device. We need to record and analyze the operation time and the number of fluoroscopy, postoperative internal fixation imaging, knee function and complications.Results There were 54 patients in P-MTBW group and 58 patients in C-MTBW group. There were statistically significant differences(P＜0.001) in the operation time between P-MTBW group (39.5±4.7; range, 32–49 minutes) and C-MTBW group (53.7±6.8; range, 42–71 minutes). The number of intraoperative fluoroscopy was significantly less (P＜0.001) in P-MTBW group(4.2±1.4) versus that of C-MTBW group (8.3±2.7). According to Iowa knee score, there was no significant difference (P=0.268) in function between the two groups. According to our own evaluation criteria for MTBW, anyone in the P-MTBW group was excellent and 26 patients were excellent, 20 patients were good and 2 patients were fair in the C-MTBW group.Conclusion The navigation device can reduce operation time and intraoperative fluoroscopy frequency. P-MTBW fixation is an accurate and effective surgical procedure for patella fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application

Wang

Xiong

Long

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Although there are new techniques such as cannulated screw tension band [11,12], cable pin system [13] and patella plate [14], the MTBW is still the most widely accepted surgical method for the treatment of patellar transverse fracture [7]. The MTBW technique is easy to operate on and economical to reduce the burden on patients, and the key of MTBW technique is to keep two k-wires parallel [8,15].…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, the technique of modi ed tension band wires (MTBW) has been the most commonly used surgical procedure and is considered the gold standard for transverse patella fracture [4][5][6][7]. This technique consists of two parallel K-wires perpendicular to the fracture line and an eight-shaped wire passing anteriorly over the patella and behind the K-wires.…”

Section: Introductionmentioning

confidence: 99%

A precise navigation device for fixation of patella fractures with modified K-wire tension band: A comparative retrospective study

Wang

Xiong

Long

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Traditionally, the technique of modified tension band wires (MTBW) has been the most commonly used surgical procedure. The purpose of this study is to design a precise navigation device that can obtain a standard position of K-wires for (MTBW), and to compare the precise MTBW (P-MTBW) by a navigation device with the conventional MTBW (C-MTBW) by hands in a retrospective study.Methods The device was designed by solidworks2012 software (USA), which could provide a precise guidance for obtaining a parallel K-wires. Besides, it could set the distance between two k-wires and the level of k-wires below patellar anterior surface. From June 2014 to August 2018, a total of 112 patients were employed in this retrospective study. The patients were divided into P-MTBW group and C-MTBW group according to the surgical technique with or without the precise navigation device. We needed to record and analyze the operation time and the number of fluoroscopy, postoperative internal fixation imaging, knee function and complications.Results There were 54 patients in P-MTBW group and 58 patients in C-MTBW group. There were statistically significant differences(P＜0.001) in the operation time between P-MTBW group (39.5±4.7; range, 32–49 minutes) and C-MTBW group (53.7±6.8; range, 42–71 minutes). The number of intraoperative fluoroscopy was significantly less (P＜0.001) in P-MTBW group(4.2±1.4) versus that of C-MTBW group (8.3±2.7). According to Iowa knee score, there was no significant difference (P=0.268 at one year) in function between the two groups. According to our own evaluation criteria for MTBW, anyone in the P-MTBW group was excellent and 26 patients were excellent, 20 patients were good and 2 patients were fair in the C-MTBW group.Conclusion The navigation device can reduce operation time and intraoperative fluoroscopy frequency. P-MTBW fixation is an accurate and effective surgical procedure for patella fractures.

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“…[2][3][4] For this purpose, various fixation methods have been introduced. [4][5][6][7] The most common type of fixation method used for transverse patella fracture is modified tension band wiring using two Kirschner wires (K wires) (TBWKW) across the fracture site with a figure of eight pattern cerclage wiring (Figure 1(a)). 3 Although there is a high union rate, various complications including protrusion and extrusion of the implant resulting in pain and wound problem have been reported.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins

Lee

et al. 2019

J Orthop Surg (Hong Kong)

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Purpose: The purpose of this study is to compare biomechanical characteristics of tension band wiring using Kirschner wires (TBWKW), cannulated screws (TBWCS), and ring pins (TBWRP) for transverse fracture of the patella. Methods: A total of 48 polyurethane synthetic patellae were biomechanically tested. All patellae were osteotomized to create a transverse fracture. Each TBWKW, TBWCS, and TBWRP fixed 16 broken patellae. A specially designed fixation board simulated a knee with 90° flexion. Ten static tests and six dynamic tests were performed on each method. The static test is measuring maximum strength ( N) during traction until breakage of the fixation. The dynamic test consisted of measuring the fracture gap (mm) after 10,000 repetitive loading cycles between 100 N and 300 N that simulated actual daily activity. A gap of 2 mm or more was defined as a failure in both tests. Result: The failure load was 438.6 ± 138.6 N, 422.2 ± 72.7 N, and 1106.8 ± 230.3 N for TBWKW, TBWRP, and TBWCS, respectively. TBWCS showed a statistically significant difference compared to TBWKW and TBWRP in the static test ( p < 0.001). All the groups had no failure in the dynamic test. The mean fracture gap after completion of the dynamic test was 0.3267 ± 0.3395 mm, 0.2938 ± 0.2165 mm, and 0.0360 ± 0.0570 mm for TBWKW, TBWRP, and TBWCS, respectively ( p = 0.044). The mean values in the dynamic test showed no statistical difference. There was a significant difference between TBWRP and TBWCS ( p = 0.009), but others showed no difference with statistical significance. Conclusion: All three methods have sufficient stability at a daily activity. TBWCS showed a better failure load compared with TBWKW and TBWRP. TBWRP showed compatible mechanical characteristics with traditional tension band wiring. TBWRP could be an alternative method for TBWKW.

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Treatment of Patella Fractures

Cited by 56 publications

References 84 publications

A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application

A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application

A precise navigation device for fixation of patella fractures with modified K-wire tension band: A comparative retrospective study

Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins

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