Objectives: To evaluate a modified tension band Osteosynthesis wiring method for closed transverse patellar fractures and compare the outcomes with conventional tension band wiring Osteosynthesis for the same.
Material and methods: This Prospective interventional study was conducted at Private medical centers and the department of Orthopaedics, Lady Reading Hospital, Post Graduate Medical Institute, Peshawar. From 18thMarch, 2009 till 17th March, 2012 consecutively patients were allocated to group1 and group2. In group 1 the conventional where as in group 2 the modified techniques were used. Following discharge all patients were advised follow up visits at the outpatient department at 2 weeks, 1month, 3 months, 6 months and 12 months. Efficacy of either procedure was assessed by comparing the frequency of complications, range of motion, quadriceps wasting, quadriceps power, extension lag and knee pain.
Results: The mean age in both groups was similar (31.58+8.55 and 31.34+6.74) as was the male to female ratio. On the completion of three months 16 cases (24.6%) presented with radiological evidence of non union following surgery that was more frequent in group 1. Fifteen patients (23.07%) from both groups had gross evidence of quadriceps wasting 11 (66.6%) of which were from group 1. At 12 months 13 patients (39.39%) from group 1 versus 11 patients (34.37%) from group 2 had evidence of extension lag in comparison to the contra lateral limb. By the end of 12th months only 7 patients (10.76%) had power of less than 90% comparing to the normal limb.
Conclusion: The modified technique explained in this study has a better long-term outcome as compared to the conventional technique with cerclage wiring.
Key words: Patella, Fracture, Tension band wiring, Quadriceps.
Patella, Fracture, Tension band wiring, Quadriceps.