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Tension Band Wiring in Gap Non-union Patella - A Simple Technique with Profound Results: Case Report
Harshita Udiwal1, Akshay Sharma1, Vikramaditya Rai1
1Department of Orthopaedic Surgery, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India.
Introduction:
Gap non-union patellas are challenging to treat for an orthopedic surgeon. We hereby report a case of a 22-year-old person with a 3 cm gap nonunion, its surgical management, functional outcome, and implications for clinical practice.
Case Report:
A 22-year-old active male presented to us with a background of comminuted fracture patella left side that he suffered 1 year ago, following which he was treated by open reduction and internal fixation (ORIF) with Tension Band Wiring (TBW). One year post-surgery, the patient had another fall, following which he had pain swelling in his left knee and difficulty in his knee extension. The patient presented 6 months later with painful ambulation and a swelling left knee. A 3 cm gap along with underlying implants could be palpated. The patient underwent surgery in the form of previous implant removal, freshening and apposition of fracture ends, and single-staged reconstruction of the extensor mechanism using TBW. The patient had full range of motion at the 1-year follow-up.
Conclusion:
The present case highlights the fact that small-gap non-union patella can be managed simply as a single-stage procedure with ORIF and TBW.
