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A Comparative Study of Modified Tension Brand Wiring and Cerclage Wiring in Management of Transverse Fractures of Patella
Management of patellar fractures is controversial. This study compares the results of two commonly used methods of internal fixation for transverse fractures of patella namely cerclage wiring and modified tension band wiring. Outcome of treatment of twenty (20) cases of transverse fractures of patella from the 2 hospitals attached to the MRMC Medical college, Gulbarga, India were studied between March 2003 to February 2005. Group -A consist of 10 cases which were treated with modified tension band wiring and group-B consist of 10 cases treated with cerclage wiring. Union was achieved in all 20 cases results were compared by using modified Bostman scale. Nine out of 10 patients treated with modified tension band (Group-A) has excellent to good results, 7 patients had knee flexion more than 120°, 8 patients had near normal quadriceps power and 1 patient had extensor lag. In group-B which were treated with cerclage 8 out of 10 patients had excellent to good results, 6 of them had knee flexion of more than 120°, 7 of them had near normal quadriceps power and 2 of them developed extensor lag. Out of 20 cases, 3 cases were compound Grade-I. All 3 cases healed satisfactory, one developed infection leading to stiffness. The results were comparable to closed group. Quadriceps wasting were seen in all 20 cases but it was minimal in group-A treated with modified tension band wiring may because of shorter period of immobilization. It was found that the results of all the cases were comparable but cases treated with modified tension band wiring showed better results as compared to cerclage wiring as the stability of implant is better and post operative rehabilitation is faster. Compound grade-I fractures of patella shows good results when treated by internal fixation.
Fractures, Patella, Injuries, Cerclage, Quadriceps, Health Care
- Berg EE (1997) Open reduction internal fixation of displaced transverse patella fractures with figure of 8 wiring through parallel cannulated screws. J. Ortho Trauma. 1(8), 573-576.
- Bostman O, Kiviluoto O and Nirhamo J (1981) Comminuted displaced fractures of the patella injury. British J. Accident Surgery. 13(3), 196-202.
- Bostrom A (1972) Fractures of patella– A study of 422 patellar fractures. Acta Orthop. Scand Suppl. 143, 1-80.
- Canale ST (1998) St. Louis Campbell’s operative orthopedics. 9th Edition. MY press, Vol. 3. pp:2111- 2114.
- Chaurasia BD (1992) Human anatomy. 2nd Edition. CBS Publ. & Distributors, Delhi. Vol. 2. pp;124-131.
- Srinivaslu K, Sanjiv K, Marya S, Surya Bhan and Dave PK (1986) Results of surgical treatment of patellar fractures. Indian J.Orthop. 20(2).158-161.
- Depalma A F (1954) Diseases of the knee. J. B. Lippincott. 3rd edn. Philadelphia. pp: 218.
- Dudani B and Sancheti KH (1981) Management of fracture patella by tension band wiring. Indian J. Orthopedics. 15(1), 4348.
- Edwards SB, Johnell O and Redlund-Johnell I (1989) Patella fractures– a 30 years follow-up. Acta Orthop. Scand. 60, 712-714.
- Einola S, Aho AJ and Kallio P (1976) Patellectomy after fracture long-term follow-up results with special reference to functional disability. Acta Orthop. Scand. 47(4), 441-447.
- Fairbank H (1945) Excision of patella. Br. Med. J. 2, 195-196.
- Haxton HA (1945) Functions of patella and effects of its excision. Surgery Gynac. Obst. 80, 389-395.
- Heineck AP (1909) The modern operative treatment of fractures of the patella – an analytical review of over 1100 cases treated by operative methods. Surg. Gynaec. Obstet. 9, 177-248.
- Instructional Course Lectures (1993) AAOS fractures of Patella. J. Bone Joint Surg. 75A: 10-15.
- Jakobsen J, Christensen KS and Rasmussen OS (1985) Patellar fracture treatment. Orthop Scand. 56, 430-432.
- Kaufer H (1971) Mechanical functions of patella. JBJS. 53A, 1551-1552.
- Kaufer H (1979) Patella biomechanics. Clin. Orthop. 144, 51-54.
- Levack B, Flanagan JP and Hobbs S (1985) Results of surgical treatment of patellar fractures. J. Bone Joint Surg. 67(3), 416-419.
- Merchant AC, Mercer RL, Jacobsen RH and Cool CR (1974) Roentenographic analysis of patellofemoral congruence. J. Bone Joint Surg. 56, 1391-1396.
- Weber MJ, Janecki CJ, McLeod P, Nelson CL and Thompson JA (1980) Efficacy of various forms of fixation of transverse of the patella. J. Bone Joint Surg. 62A, 215-220.
- Muller MC, Allgomer R and Willengger H (1970) Manual of internal fixation – recommended by AO group. Springer, NY, 3rd Edition. pp:175.
- Ozdemar H and Ozenci M (2001) Outcome of surgical treatment of patellar fractures trauma. Resg. 1, 56-59.
- Park MS, Chung CY, Lee KM, Lee SH and Choi IH (2010) Which is the best method to determine the patellar height in children and adolescents? Clin. Orthopaedics & Related Res. 468(5),1344-1351.
- James H. Beaty (2009) Rockwood & Green’s fractures in adults. 7th Ed. Vol. 2, pp: 1956-1972.
- Rudolph Reich & Rosenberg (1954) Treatment of partellar fractues. Surg. Gynac. & Obst. 98, 556-560.
- Scapinelli R (1967) Blood supply of human patella: Its relation to ischemic necrosis after fracture. J. Bone & Joint Surg. (Br), 49(3), 563-570.
- Shobat S, Mann G (2003) Functional results after patellar fractures.Arch.Gerontol.Geriator.37(1),93-98.
- Shrinivas K, Suryaprakasrao V, Narendranath L and Prasadrao VBN (2004) Evaluation of results of surgical treatment of closed fractures of patella. Indian J. Orthop. 38, 104-106.
- Smillie LS (1970) Injuries of the knee joint. 4th Edn. E&S Livingstone, Edinburgh.
- Smith ST, Cramer KE, Krages DE, Watson JT and Moed BR (1997) Early complications in operative treatment of patellar fractures. J. Orthop. Trauma. 11(3), 183-187.
- Watson Jones (1954) Excision of patella. Br.J. Med. 2, 195-196.
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