Journal of Musculoskeletal Trauma

Clinical Outcomes of Triple Tension Band Wirings in Comminuted Patellar Fracture: A Comparison with Conventional Tension Band Wiring: Hyun-Cheol Oh, Han-Kook Yoon, Joong-Won Ha, Sang Hoon Park, Sungwoo Lee; J Korean Fract Soc 2024;37(2):82-86. Published online April 30, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.2.82

Abstract PDF: Purpose
This study devised triple tension band wirings (TTBW) fixation in patients with comminuted patella fractures to compare the clinical result of TTBW with that of tension band wiring (TBW).
Materials and Methods
This study was conducted on 91 patients who had undergone surgery diagnosed with acute patella fracture from January 2011 to December 2016. The study included 51 double TBW patients (Group 1) and 40 patients with TTBW (Group 2).
Results
Five out of 51 cases had a loss of reduction and fixation failure in Group 1, and no failure of fracture formation healing occurred in Group 2. Nonunion was noted in one case in Group 1 and no case in Group 2. Eight K-wire migration cases were observed in Group 1, which was not observed in Group 2. Six patients in Group 1 underwent revisional surgery. No patients in Group 2 had a reoperation. As a result of a one-year follow-up after the operation, the mean range of motion of the knee joint in groups 1 and 2 was 128.3°±11.3° and 127.9°±10.8°, respectively. The Lysholm’s scores for groups 1 and 2 were 90.8±4.2 and 90.3±3.8 points, respectively, which was not statistically significant.
Conclusion
TTBW is a helpful technique for the surgical treatment of comminuted patella fractures. The TTBW method has less reoperation due to nonunion and fixation failure. After a one-year followup, the clinical results were similar to the conventional TBW method.

36 View
0 Download

Usefulness of Percutaneous Cannulated Screws with Tension Band Wiring for Minimally Displaced Fractures of the Patella: Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Eun Woo Bae; J Korean Fract Soc 2022;35(4):142-150. Published online October 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.4.142

Abstract PDF: Purpose
To evaluate the usefulness of percutaneous cannulated screws with tension band wiring (PC-STBW), a minimally invasive surgical technique, compared to conservative treatment for a minimally displaced patella transverse fracture.
Materials and Methods
The subjects included patients from 2010 to 2019 with transverse patella fractures, who were diagnosed as minimally displaced fractures, and were followed up for at least 1 year. Of these, 61 patients who were treated with cylinder casts were classified as Group A, and 53 patients who were treated with PCSTBW were classified as Group B. The clinical evaluation was carried out by evaluation of the radiographic bone union and calculation of the Bostman knee score. Any complications observed were investigated.
Results
All patients in both groups showed no further displacement of the fracture gap, and the bone union was achieved in all cases. The functional evaluation of the knee joint measured at the 8- and 12-week follow-up showed superior results in Group B wherein subjects were treated with surgery, and similar results were seen in both groups during the 6 months and 1-year follow-up. One case in Group A suffered the complication of knee stiffness.
Conclusion
For the treatment of minimally displaced transverse patellar fractures, both conservative treatment and PCSTBW showed similar good results at the 6-month and one-year follow-up. However, the PCSTBW technique showed superior clinical results in the early stage follow-up within 12 weeks.

25 View
0 Download

Modified Tension Band Wiring Combined with Anti-Gliding Loop Augmentation Technique for the Treatment of Comminuted Patellar Fracture: Technical Note and Report of Early Results: Technical Note: Han Jun Lee, Jae Jun Yang, Ho Joong Jung, Hyoung Seok Jung; J Korean Fract Soc 2013;26(4):321-326. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.321

Abstract PDF: In order to investigate the feasibility of a modified tension band combined with anti-gliding loop augmentation technique for the treatment of comminuted patellar fracture, 21 patients with comminuted patellar fracture were enrolled in this study. After the modified tension band wiring of patellar fracture, a cerclage wire was passed around the patella. Anti-gliding loops were made on the bending sites of Kirshner-wires. A knot was tied using both ends of the anti-gliding loops, and the cerclage wire was tightened using proximal knots. Bone union was achieved at 4.5+/-1.5 months postoperatively without nonunion. The Lysholm score was 87.1+/-2.8, and the range of motion of the knee was 2.1degrees+/-3.4degrees to 132.2degrees+/-6.5degrees at the last follow-up. The modified tension band combined with anti-gliding loop augmentation technique might be considered an alternative modification of modified tension band wiring for the treatment of comminuted patellar fracture.

30 View
0 Download

Heterotopic Ossification around Patellar Tendon Following Treatment of Patellar Fracture: A Case Report: Sang Jin Lee, Ji Wan Kim, Dong Hyun Lee, Jae Young Lim; J Korean Fract Soc 2013;26(1):73-76. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.73

Abstract PDF: Heterotopic ossification around the patellar tendon is known to be extremely rare. A 42-year-old man had a transverse fracture of the left patella. Open reduction and tension band wiring were performed. At four weeks, plain radiographs showed an extensive ossification around the patellar tendon and the patient presented limitation of flexion and pain in kneeling position. We just encouraged active and passive ranges of motion exercises and performed one manipulation under anesthesia. At the final follow-up (10 months post-operatively), he was able to flex his knee by 140 degrees. We present a case of heterotopic ossification around the patellar tendon with limitation of knee flexion that was successfully treated with nonoperative treatment.

33 View
0 Download

The Treatment of Patellar Fracture with Modified Tension Band Wiring, using Cannulated Screws: Chul Won Ha, Jong Il Sun; J Korean Fract Soc 2004;17(2):117-121. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.117

Abstract PDF

PURPOSE
We have followed up the patients of the patellar fracture who had been treated with modified tension band wiring using cannulated screws. Since we have seen excellent clinical results, we would like to show the practical use of this operative method.
MATERIALS AND METHODS
We analyzed the operation time, the time elapsed for union, and complications of 9 cases of the patellar fracture who were treated with this operative method at our hospital recently.
RESULTS
Mean operation time (from the incision to the skin suture) was 68.3 min (40~120 min) and mean time elapsed for union was 9.7 weeks (8~12 wks). Mean time for full range of motion was 1 week in 5 cases of transverse fracture, 3 weeks (2~4 wks) in 3 cases of comminuted fracture. We found no complications like limitation of range of motion of the knee, loss of the reduction, irritation and migration of the hardware, and infection.
CONCLUSION
This surgical technique provides stable fixation, allowes early motion excercise by minimizing injury to extensor mechanism and accompanies reduced rate of complications such as loss of the reduction, irritation or displacement of the hardware

Citations

Citations to this article as recorded by

Evolution in the Management of Patella Fractures
Mahak Baid, Sid Narula, Jonathan R. Manara, William Blakeney
Journal of Clinical Medicine.2024; 13(5): 1426. CrossRef
Results of Tension Band Wiring and Additional Circumferential Wiring in Treatment of Comminuted Patella Fracture
Young Min Lee, Kook Jin Chung, Ji Hyo Hwang, Hong Kyun Kim, Yong Hyun Yoon
Journal of the Korean Fracture Society.2014; 27(3): 206. CrossRef
Treatment of Transverse Patellar Fracture with Cannulated Screws
Jung-Man Kim, Ju-Seok Yoo, Yong-Jin Kwon, Jang-Ok Cheon
Journal of the Korean Fracture Society.2007; 20(2): 149. CrossRef

34 View
1 Download
3 Crossref

Treatment of patellar Fractures with Modified Tension Band Wiring: Myung Hwan Son, Byung Chul Kim, Nam Wook Kang, Tae Young Choi; J Korean Soc Fract 1999;12(4):872-878. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.872

Abstract PDF

The aim of treatment of patellar fracture is the restoration of knee joint function and quadriceps muscle power. Comminuted and displaced fracture of the patella, which are difficult to reduce accurately and to get stable internal fixation, may lead to traumatic osteoarthritis, chondromalacia, limited ROM of the knee joint. In this series, we treated 29 cases of displaced transverse and comminuted fractures with modified tension band wiring. In severely comminuted fractures, the fragments were indirectly reduced by cerclage wire and then fixed with modified tension band wiring. We could obtain stable fixation and early ROM of the knee joint. There were 5 complications including wire breakage and wire loosening. In this respect, we concluded that modified tension band wiring was a good method for displaced transverse and comminuted patellar fracture.

Citations

Citations to this article as recorded by

Circumferential Wiring Combined with Tension Band Wiring in the Operative Treatment of Patella Fracture
Jae-Chun Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2014; 27(1): 65. CrossRef

32 View
0 Download
1 Crossref

Operative Treatment of patellar Fractures: Chang Kwan Kim, Jeong Hwan Kim, Sang Yup Lee, Young Hwan Kim, Chae Ik Chung, Jeong Gee Hong; J Korean Soc Fract 1999;12(4):858-864. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.858

Abstract PDF: We studied 45 patients of patella fracture who were treated by surgical method from March 1990 to December 1991. The results were analysed to evaluate the functional results of the knee according to methods of fixation and severity of comminution. The results were as follows. 1. Out of 45 cases, 11 cases were tredted by tension band wiring, 19 cases by modified tension band wiring, 5 cases by tension band wiring by circumferential wiring, 8 cases by circumferential wiring, and 2 cases by screw fixation. 2. The mean fracture healing period was 6.9 weeks in cases of tension band wiring, 6.5 weeks in cases of modified tension band wiring, 5.2 weeks in cases of tension band wiring with circumferential wiring, and 7.3 weeks in cases of circumferential wiring. 3. The most favorable result was obtained in cases which were fixed with tension band wiring and circumferential wiring. 4. Modified tension band wiring seems to be a good method for displaced transverse fracture and comminuted fracture with large fragments and tension band wiring with circumferential wiring is for severely comminuted fracture with small fragments.

27 View
0 Download

Treatment of Patella Fracture Using Modified Transverse Tension Band Wiring Method: Jung Dae Oh, Cyeong Rim Lim, Yu Jin Joung, Gyu Sung Lee; J Korean Soc Fract 1998;11(4):858-864. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.858

Abstract PDF: Recently the fracture of patella has increasing tendency due to frequent traffic and industrial accidents. In this series, we treated fractures of patella by open reduction and internal fixation with modified transverse tension band wiring method. Early post operative continuous passive motion and early weight bearing exercise were followed. This method was excellent for treatment of the patella fractures. The surgical results were evaluted by Leveck scoring systems, 12 out of 14 cases had satisfactory results. This technique have some advantage in terms of decreasing pain and maintenance of circulation on the patella, because of the small incision and minimize dissection. It can prevent post operative complications such as limitation of motion and post traumatic arthritis of the knee joint.

26 View
0 Download

Severe Comminuted and Displaced Patellar Fracture Treated by Partial or Total Patellectomy: Kuen Tak Suh, Taek Geon Lee, Weon Wook Park, Chong Il Yoo, Kyu Yeol Lee, Bu Hwan Kim; J Korean Soc Fract 1997;10(4):851-859. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.851

Abstract PDF: The results of partial and total patellectomy as a treatment for severe comminuted and displaced patellar fracture were assessed retrospectively with the use of clinical criteria and radiologic findings. Sixteen patients treated with patellectomy(four total and twelve partial patellectomies) were followed up for an average of 3 years 4 months and valuated. According to the Bostmans fracture classification, there were type I In 5 cases(31%), type II in 7 cases(44%), and type III in 4 cases(25%). The results of the patellectomy were relatively good since excellent result was shown in 11(69%) among 16 cases. The comparison between partial and total patellectomy was difficult because the fracture patterns treated by these techniques were different. In this study, the result of the partial patellectomy was better than that of the total patellectomy, but their difference was not statisticaliy significant(P>0.05). The results of the study indicated that partial or total patellectomy could be one of the effective treatment methods for severe comminuted and displaced patellar fracture. However total patellectomy should be recommended only when the entire patella was too severely comminuted to function as a part of the extensor mechanism of the knee.

29 View
0 Download

The Clinical Result of Operative Treatment of the Comminuted Patellar Fractures : A Comparison of Clinical Results According to the Operative Methods and the Postoperative Cares: Byeong Yoen Seong, Jong Hoon Lee, Seung Jun Park; J Korean Soc Fract 1997;10(3):604-613. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.604

Abstract PDF: Approximately one third of patellar fractures require surgery and stellate and comminuted frachres of the patella has been increased. Operative treatment of the patella should be achieved to ensure continuity of the extensor mechanism, to preserve patellar function and reduce the incidence of complications related to articular fracture. Various techniques of internal fixation have been recommended for comminuted fracture of De patella, but there are some complications including loss of fragment position, reoperation, nonunion, loss of range of motion and loss of extensor mechanism strength. The evaluation of the clinical results in rigid fixation group which was made postoperative excercise from postoperative 2 weeks without cylinder cast application, was needed for the purpose whether or not to decrease those complications. We reported 46 cases of comminuted patellar fracture who were operated various methods with or without cylinder cast as postoperative care, from Jun 1990 to Dec 1995 at the department of orthopaedic surgery, Dongrae Bongsaeng hospital. In conculsions, rigid fixation as using Kirschner wires with modified anterior tension band and a circumferential wiring and early motion without cylinder cast for the comminuted patellar could be increased the fusion rate and range of motion and recovered function of the knee joint.

19 View
0 Download

Operative Treatment of Patellar Fracutres: Eun Kyoo Song, Dae Ik Kim, Hyung Seog Kim; J Korean Soc Fract 1996;9(3):640-646. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.640

Abstract PDF: Patella has important roles to enhance extensor mechanism of knee, therefore patellar fractures should be treated correctly according to the type and displacement of fractures for the preservation of patellar function. The purpose of study is to analyse the clinical results of operative treatment for patellar fractures. 77 cases of patellar fracture which were treated at Chonnam University Hospital between June 1985 and March 1995 were reveiwed. Among them, 32 cases with open reduction and internal fixation were included in this study. The mean follow-up period was 21.5 months(range twelve to eighty two months). Oircurnferential wiring, modified tension band wiring, malleolar screws and combination of circlage and tension band wiring were used as a fixatives. The clinical results were compared according to Reileys clinical evaluation criteria mainly by range of motions, mid-thigh circumferential difference. The most favorable results could be obtained with the combination of circlage and tension band wiring.

22 View
0 Download

Clinical study of patellar fracture: Sang Won Park, Kyung Jo Woo, Young Soo Byun; J Korean Soc Fract 1991;4(1):112-118. Published online May 31, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.1.112

Abstract PDF

No abstract available.

Citations

Citations to this article as recorded by

Changes in patellar fracture characteristics: A multicenter retrospective analysis of 1596 patellar fracture cases between 2003 and 2017
Seong-Eun Byun, Jae-Ang Sim, Yong Bum Joo, Ji Wan Kim, Wonchul Choi, Young Gon Na, Oog-Jin Shon
Injury.2019; 50(12): 2287. CrossRef
Circumferential Wiring Combined with Tension Band Wiring in the Operative Treatment of Patella Fracture
Jae-Chun Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2014; 27(1): 65. CrossRef

31 View
0 Download
2 Crossref

Clinical Investigation of the Comminuted Patellar Fracture: Chang Ju Lee, Won Ho Cho, Ho Guen Chang, Yoo Geun Ju; J Korean Soc Fract 1990;3(2):209-215. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.209

Abstract PDF: The authors report a clinical experience of 12 cases having comminuted patellar fracture who were treated with modified tension band wiring or partial patellectomy from January 1985 to Oecember 1989 at the department of Orthopedic Surgery, Hallym University Hangang Sacred Heart Hospital. The results were as follows 1. All cases caused by direct blow. 2. Mean immobilization period was 5 weeks in modified tension band wiring, mean immobilixation was 3.3 weeks in partial patellectomy. 3. Range of motion of knee joint was 3-123 in modified tension band wiring, range of motion of knee joint was 5" -110" in partial patellectomy. 4. Quadriceps muscle weakness was developed in all of 2 cases of partial fatellectomy. 5. Extension lag of knee joint was developed in 1 case of partial patellectomy. 6. The result of modified tension band wiring was much better than partial patellectomy in comminuted patellar fracture.

21 View
0 Download

Tension band wiring and Modified tension band wiring in the Operative Treatment of Patella Fracture: Sang Ho Ha, Sang Hong Lee, Dong Min Shin, Young Bae Pyo; J Korean Soc Fract 1990;3(1):46-52. Published online May 31, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.1.46

Abstract PDF: The authors report a clinical experience of 25 patients having patellar fracture who were treated with tension band wiring or modified tension band wiring from January 1984 to December 1988, at the Department of Orthopedic Surgery, Cho-Sun University Hospital. The results were as follows. 1. Out of 25 cases were treated by modified tension band wiring and remaining 5 cases were treated by tension band wiring. 2. The mean fracture healing period was 5.8 weeks in cases of modified tension band wiring and 6.8 weeks in tension band wiring. 3. Fixation by tesion band priciple has given acceptable results in comminuted fractures and transverse fractures both.

27 View
0 Download

Change of Patellar Length after Internal Fixation of the Patellar Fracture: Min Jong Lee, Sang Soo Kim, Kyung Youl Jhon; J Korean Soc Fract 1989;2(2):234-245. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.234

Abstract PDF: As fracture of the patella may casue loss of continuity of the extensor mechanism and incongruity of the patellofemoral joint, the aim of treatment is to restore function and strength of the knee and to minimize posttraumatic osteoathritis by closed or open methods. To know which method is adequate to fixation of the patellar fractures, the authors reviewed 35 cases of the patellar fractures, which were treated with K-wire fixation, circumferential wiring, modified tension band wiring or combined circumferential wiring with modified tension band wiring, with radiological change of patellar length after exercise, and obtained the following results: 1. Postoperative lengthening of the patea occurred in 17 out of 35 cases(49%) and the range was 1.3 to 8.0mm, mean 3.1mm 2. Patellar lenthening occurred in cases with K-wire fixation or cirumferential wiring more than modified thension band or combined circumferential wiring with modified tension band fixation. 3. Modified tension band added to circumferential wiring may be obtained more rigid fixation in comminuted fracture, especially.

28 View
0 Download

Search