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Category: Volume 05 Issue 11 November 2017
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Title: A Prospective Clinical Study of Patellar Fractures Treated by Modified Tension Band Wiring

Authors: Dr L.G. Vishali, Dr Venkat Lakavath, Dr S. Laksminarayana

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.133

Abstract

Background: Patellar fractures constitutes about 1% of all skeletal injuries resulting from either direct or indirect trauma. Patella is of importance for the extension of knee joint, which increases the force of quadriceps apparatus by improving the leverage, in addition it protects the anterior surface of distal femur against external violence but may be easily injured due to unprotected position. Any compromise of the joint surface is likely to lead to degenerative joint disease. It is therefore, highly desirable, in patellar fractures to strive for anatomical reduction of the joint surface and stable fixation.

Objectives: To determine the demographic profile (age and sex distribution) of our patients with fracture patella.

To study the functional outcome by early mobilization.

To study the complications of tension band wiring.

To clinically evaluate the tension band wiring technique for fracture patella.

To assess knee joint motion and stability after the procedure.

To study the mode of injury for fracture patella.

Methods: This prospective study is consists of 40 selected cases of fractured patella treated by  modified tension band wiring at the Kakatiya Medical College, MGMH, Warangal from July 2015 to October 2017.

Results: 40 cases of fracture patella treated by tension band wiring technique at Kakatiya Medical College, MGM Hospital, Warangal. have been presented. Maximum number of cases 11 (27.5%) were in the age group of 41-50.There was male sex predomination, 29(62.5%) were males and 11(27.5%) were females. Right side fractures were common with 25(62.5%) cases. 31(77.5%) cases are due to an indirect trauma to the knee joint, direct injury resulted fracture patella in 9(22.5%) cases. 26(65%) cases are transverse fractures and 14 (35%) cases had comminuted fractures. Subjective complaints like mild pain was observed in 6(15%) patients and moderate pain was observed in 2(5%) patients.

8(20%) patients had flexion limitation, quadriceps wasting was observed in 8(20%) patients a quadriceps power of grade-4 was observed in 8 (20%) patients. Extensor lag of 5 to 10 degrees was seen in 2 cases(5%), 32 (80%) cases had excellent result, 6 (15%) cases had good results and 2(5%) cases had poor results  based on WEST"S CRITERIA following   modified tension band wiring procedure.

Keywords: Patella, Fractures, Treatment, Tension band Wiring.

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Corresponding Author

L.G. Vishali

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