From the Research
The primary purpose of a patellar tension band wire in orthopedic surgery is to convert tensile forces into compressive forces across the fracture site, providing excellent stability that allows for early mobilization and preventing joint stiffness while maintaining the biomechanical function of the knee extensor mechanism during healing. The procedure involves placing two parallel Kirschner wires (K-wires) across the fracture, followed by a figure-of-eight wire wrapped around the K-wires to create compression, as described in the study by 1. This technique is most effective for transverse patella fractures where the extensor mechanism remains intact. Key points to consider when using this technique include:
- The surgery typically requires a longitudinal midline incision over the patella, with careful reduction of the fracture fragments before wire placement 1.
- Postoperatively, patients usually wear a hinged knee brace with progressive range of motion exercises starting within 1-2 weeks 1.
- Weight-bearing is often allowed as tolerated with the brace locked in extension for walking 1.
- Physical therapy focuses on quadriceps strengthening and range of motion exercises 1.
- Hardware removal may be necessary in 30-50% of cases due to wire prominence causing skin irritation, as noted in the study by 1. The modified anterior tension band (MATB) technique, which consists of two longitudinal 1.8 mm Kirschner wires (K-wires) and an 18-gauge stainless steel wire looped in a figure-of-8 pattern over the anterior aspect of the patella, is the most widely accepted method of internal fixation for transverse and comminuted patellar fractures, with good to excellent clinical results (64-100 %) reported in the literature 1.