Abstract: Introduction: Patella fractures are common and it constitutes about 1% of all skeletal injuries resulting from either direct or indirect trauma. The subcutaneous location of the patella makes it vulnerable to direct trauma as in dashboard injuries or a fall on the flexed knee, whereas violent contraction of the quadriceps results in indirect fractures of patella. These fractures are usually transverse and are associated with tears of medial or lateral retinacular expansions. In this study a series of 30 cases of fracture patella were studied after treating with Modified Tension Band Wiring technique.
Methods: This prospective study was done in Department of Orthopaedics at Balaji Institute of surgery research and rehabilitation for the disabled (BIRRD) Hospital, Tirupati, Andhra Pradesh during the period from November 2013 to May 2015 over a period of one and half year. This study consists of 30 cases of fracture patella treated by modified tension band wiring. The cases were selected based on inclusion and exclusion criteria.
Inclusion criteria
1.All closed and type I and type IIopen displaced transverse patellar fractures.
2.Transverse fracture with displacement of more than 2 to 3 mm and articular step of more than 2mm.
3.Comminuted fractures where reconstruction and fixation by modified tension band wiring is possible.
Exclusion criteria
1.Type III compound fractures.
2.Grossly comminuted, vertical or marginal fractures.
3.Old fractures (more than 2-3 weeks).
4.Pathological fractures.
Conclusion: Our study shows that modified tension band wiring is a definitive procedure in management of displaced transverse patellar fracture with least complications and also helps for early mobilization post-operatively. In our study we observed excellent result in 86.6% and good in about 10% and poor in 3.3% of cases. 4 Out of 30 cases had complications. Early post-operative Physiotherapy is a very essential tool of success in the management of these fractures, which helps in reducing complication like stiffness of knee and in providing good function. Long-term follow up is necessary to assess late complications like osteoarthritis and late functional outcome.
