COMPARISION OF HORIZONTAL & VERTICAL FIGURE OF 8 TENSION BAND WIRING IN TRANSVERSE AND DISPLACED FRACTURE PATELLA

Dr. Dibyendu Biswas; Dr Avijit Basak

Volume : IX, Issue : I, January - 2020

COMPARISION OF HORIZONTAL & VERTICAL FIGURE OF 8 TENSION BAND WIRING IN TRANSVERSE AND DISPLACED FRACTURE PATELLA

Dr. Dibyendu Biswas, Dr Avijit Basak

Abstract :

Introduction : Fractures of the patella constitute almost 1% of all skeletal injuries, resulting from either direct or indirect trauma. Patellar fractures are classified as– transverse, longitudinal, polar or comminuted). However, 30 % of patella fractures require surgical intervention. Most commonly, tension band wiring utilizes two K wires and a vertically or horizontally oriented Figure of 8 construct using Stainless steel wire. Aims : To compare the results of vertically oriented figure of 8 tension band wiring versus horizontally oriented figure of 8 tension band wiring for displaced transverse fracture of patella in adults. Material & Methods : 32 patients coming at OPD & emergency of Department of Orthopaedics with displaced transverse fracture patella with in age group of 18 – 60 years treated with Tension Band Wiring (TBW)– Vertical & Horizontally orientation. Results: In our study, 32 adult patients with displaced transverse fracture of patella were randomly allocated into two group i.e. Vertical group (treated with vertically oriented figure of 8 TBW) and Horizontal group (treated with horizontally oriented figure of 8 TBW). Patients from both groups reported mild pain at two weeks. Pain, which was subsided by 4 weeks. All fractures of both group united satisfactorily 4–5 weeks after surgery. Maximum mean knee flexion for Vertical group at 4 weeks, 8 weeks and 12 weeks post operatively was 105 degrees, 134 degrees and 137 degrees respectively. Maximum mean knee flexion for Horizontal group at , 4 weeks, 8 weeks and 12 weeks post operatively was 115 degrees, 134 degrees and 136 degrees respectively. Slippage of SS wire was a fairly common complication, occurring in 37.5 % in Vertical group and 25 % in Horizontal group & the complications had no negative impact on knee ROM. Conclusion : Transverse fracture of patella in adults is best treated by open reduction and internal fixation using tension band wiring. Using a horizontal figure of 8 construct is theoretically superior to the more common vertical figure of 8 construct achieving better inter–fragmentary compression. But our study reveals the clinical & radiological outcomes of horizontal and vertical constructs to be almost identical.