Abouelwafa, A., Abdalkhalik, W., Abdelsamad, A. (2022). Evaluation of Internal Fixation of Patellar Fractures Using Cannulated Screws with Tension Band versus Modified Tension Band Wiring. test, 3(4), 32-45. doi: 10.21608/ejmr.2022.264816
Abdelhasib Ramy Abouelwafa; Waleed Said Abdalkhalik; Ayman Abdelbaset Abdelsamad. "Evaluation of Internal Fixation of Patellar Fractures Using Cannulated Screws with Tension Band versus Modified Tension Band Wiring". test, 3, 4, 2022, 32-45. doi: 10.21608/ejmr.2022.264816
Abouelwafa, A., Abdalkhalik, W., Abdelsamad, A. (2022). 'Evaluation of Internal Fixation of Patellar Fractures Using Cannulated Screws with Tension Band versus Modified Tension Band Wiring', test, 3(4), pp. 32-45. doi: 10.21608/ejmr.2022.264816
Abouelwafa, A., Abdalkhalik, W., Abdelsamad, A. Evaluation of Internal Fixation of Patellar Fractures Using Cannulated Screws with Tension Band versus Modified Tension Band Wiring. test, 2022; 3(4): 32-45. doi: 10.21608/ejmr.2022.264816

Evaluation of Internal Fixation of Patellar Fractures Using Cannulated Screws with Tension Band versus Modified Tension Band Wiring

Egyptian Journal of Medical Research
Volume 3, Issue 4, October 2022, Pages 32-45    PDF (480.05 K)
Document Type: Original Article
DOI: 10.21608/ejmr.2022.264816
Authors
Abdelhasib Ramy Abouelwafa1; Waleed Said Abdalkhalik2; Ayman Abdelbaset Abdelsamad2
1Orthopedics department, Beni-Suef Specialized Hospital, Egypt
2Orthopedics department, Faculty of Medicine, Beni-Suef University, Egypt
Abstract
The goal of this study is to evaluate both functional and radiological outcomes in patellar fractures management with both techniques; cannulated screws with tension band and modified tension band wiring. 30 patients, with displaced or mildly comminuted and partial articular patellar fractures, were randomly grouped into two groups, 15 in each group. Group 1: fixed by cannulated screws with tension band and group 2: fixed by modified tension band wiring. By comparison between types of fixation, regarding post-operative complication (loss of knee motion, loss of reduction, delayed or non-union and pain during movement) there was no statistically significant difference between types of fixation, but there was statistically significant increase hardware removal and infection in K-wires method. Cannulated screws with tension band has a better radiological outcomes and better curative effects on patella fracture with low incidence of complications. Modified tension band wiring technique despite being the traditional and most widely accepted method of transverse patella fracture fixation; it has certain distinct disadvantages.
Keywords
Patellar fractures; cannulated screws with tension band; cannulated screws with cerclage; modified tension band wiring
References
  1. Palmu, S., Kallio, P.E., Donell, S.T., Helenius, I., and Nietosvaara, Y. Acute patellar dislocation in children and adolescents: a randomized clinical trial. JBJS,2008. 90(3): p. 463-470.
  2. Gwinner, C., Märdian, S., Schwabe, P., Schaser, K.-D., Krapohl, B.D., and Jung, T.M. Current concepts review: Fractures of the patella. GMS Interdisciplinary plastic and reconstructive surgery DGPW,2016. 5.
  3. Mao, N., Liu, D., Ni, H., Tang, H., and Zhang, Q. Comparison of the cable pin system with conventional open surgery for transverse patella fractures. Clinical Orthopaedics and Related Research®,2013. 471(7): p. 2361-2366.
  4. Malik, M. and Halwai, M.A. Open reduction and internal fixation of patellar fractures with tension band wiring through cannulated screws. The journal of knee surgery,2014. 27(05): p. 377-382.
  5. Chang, C.-W., Chen, Y.-N., Li, C.-T., Chung, Y.-H., Chang, C.-H., and Peng, Y.-T. Role of screw proximity in the fixation of transverse patellar fractures with screws and a wire. Journal of Orthopaedic Surgery,2018. 26(3).
  6. Tscherne, H. and Oestern, H. A new classification of soft-tissue damage in open and closed fractures (author's transl). Unfallheilkunde,1982. 85(3): p. 111-115.
  7. Matthews, B., Hazratwala, K., and Barroso-Rosa, S. Comminuted patella fracture in elderly patients: a systematic review and case report. Geriatric orthopaedic surgery & rehabilitation,2017. 8(3): p. 135-144.
  8. Melvin, S.J. and Mehta, S. Patellar fractures in adults. JAAOS-Journal of the American Academy of Orthopaedic Surgeons,2011. 19(4): p. 198-207.
  9. Alluri, R.K., Hill, J.R., Navo, P., Ghiassi, A., Stevanovic, M., and Mostofi, A. Washer and post augmentation of 90/90 wiring for proximal interphalangeal joint arthrodesis: a biomechanical study. The Journal of hand surgery,2018. 43(12): p. 1137. e1-1137. e10.
  10. Liu, C., Ren, H., Wan, C., and Ma, J. Comparison of the Therapeutic Effects of Tension Band with Cannulated Screw and Tension Band with Kirschner Wire on Patella Fracture. Computational and Mathematical Methods in Medicine,2020.
  11. Tan, H., Dai, P., and Yuan, Y. Clinical results of treatment using a modified K-wire tension band versus a cannulated screw tension band in transverse patella fractures: a strobe compliant retrospective observational study. Medicine,2016. 95(40).
  12. Lin, T., Liu, J., Xiao, B., Fu, D., and Yang, S. Comparison of the outcomes of cannulated screws vs. modified tension band wiring fixation techniques in the management of mildly displaced patellar fractures. BMC musculoskeletal disorders,2015. 16(1): p. 1-10.
  13. Lazaro, L.E., Wellman, D.S., Sauro, G., Pardee, N.C., Berkes, M.B., Little, M.T., Nguyen, J.T., Helfet, D.L., and Lorich, D.G. Outcomes after operative fixation of complete articular patellar fractures: assessment of functional impairment. JBJS,2013. 95(14): p. e96.
  14. Lee, K.-H., Lee, Y., Lee, Y.H., Cho, B.W., Kim, M.B., and Baek, G.H. Biomechanical comparison of three tension band wiring techniques for transverse fracture of patella: Kirschner wires, cannulated screws, and ring pins. Journal of Orthopaedic Surgery,2019. 27(3).
  15. Chengxue, W., Baochang, Q., Xiangfeng, H., Yulong, H., Haipeng, Z., Tiecheng, Y., and Lei, T. A retrospective comparison of the modified tension band technique and the parallel titanium cannulated lag screw technique in transverse patella fracture. Chinese Journal of Traumatology,2014. 17(4): p. 208-213.
  16. Hoshino, C.M., Tran, W., Tiberi III, J.V., Black, M.H., Li, B.H., Gold, S.M., and Navarro, R.A. Complications following tension-band fixation of patellar fractures with cannulated screws compared with Kirschner wires. JBJS,2013. 95(7): p. 653-659.
 

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