A prospective study of surgical management of fracture patella with modified tension band wiring

Abstract

Introduction: Displaced comminuted patellar fracture requires surgical treatment. The purpose of surgical treatment is to restore the patellar articular surface and the disrupted knee extensor mechanism. Patellar comminuted fracture is a great challenge for clinical orthopaedic surgeons. The main challenge is that sometimes, it is difficult to obtain anatomical reduction and rigid internal fixation, resulting in poor functional outcome. Materials and Methods: The study was conducted in 30 patients between October 2020 to October 2021 for a period of 1 year in Department of Orthopedics, Tagore Medical College and hospital, Chennai. All the cases were fresh fractures and were traumatic in nature. 22 patients were brought to the casuality and 8 cases were admitted through the outpatient department. Results: All cases were operated using a midline anterior vertical skin incision, 80% had excellent results, with normal squatting, grade V quadriceps power and complete range of movement at knee joint. 20% of cases had difficulty in squatting, grade-IV quadriceps power and limitation of flexion. Minimal quadriceps wasting seen in 20% of cases. Conclusion: From the analysis of the present study modified tension band wiring is the gold standard technique in management of transverse fracture patella.