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Percutaneous tension band wiring for patellar fractures
Akhilesh Rathi1, M K S Swamy, I Prasantha
1Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Associated Safdarjung Hospital, New Delhi, India. drakhileshrathi@gmail.com
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 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.