Minimally invasive tension band wiring fixation for patella fractures: A study of 19 cases
Introduction: Patellar fractures constitute about 1% of all skeletal injuries and are seen frequently in the age range of 20 to 50 years. The aim of surgical treatment comprises of maximal possible preservation of patella, stable fixation resulting in the precise anatomical reduction of the articular surface and restoring the knee-extensor mechanism, thereby allowing early mobilization and satisfactory functional outcomes. Material and methods: 19 patients with transverse fracture of patella were treated in our institute, using percutaneous tension band wiring. Comminuted fractures, open fractures, patients with injury > 15 days, life threatening conditions and previous knee injury were excluded from the study. Follow-up was done at 3weeks, 6 weeks, 10 weeks and then at monthly interval for first 6 months and then at 3 monthly interval for next 12 months. Results: All patients had successful functional outcomes evaluated in terms of range of knee motion, power of knee extensors, rate of union, VAS score, Lysholm score and Knee society clinical rating scale. All patients achieved successful union with an average time for union 10.1 1.9 weeks. Excellent Lysholm and KSCRS scores were achieved at 18 months. Complications were noted only in two patients which was knee irritation. Conclusion: In our study, we concluded that percutaneous tension band wiring of patella is associated with satisfactory union rate as well as good functional outcome requiring less surgical time. Closed method can be used for displaced fractures of patella, however whether this technique can be used for comminuted fractures needs further evaluation.
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