From the Research
Step-by-Step Procedure for Fracture Patella Managed by Tension Band Wiring
The step-by-step procedure for fracture patella managed by tension band wiring can be outlined as follows:
- The patient is operated on with a modified technique of the classic tension band wiring for patellar fractures, as described in 1.
- A 4-step procedure is used, where double tension cerclage wires are wrapped under the exposed ends of the Kirschner wires (K-wires) and the tendons in a figure-of-8 fashion, as mentioned in 1.
- The K-wires should be inserted 5 mm from the anterior cortical surface of the patella, parallel in the coronal and sagittal planes, as described in 2.
- The wire should be the closest to the anterior aspect of the bone for mechanical reasons, as stated in 2.
- The modified anterior tension band (MATB) technique for fixation of patellar fractures 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, as described in 2.
Key Considerations
Some key considerations for the tension band wiring technique include:
- The both-ends K-wire bending fixation method has a lower complication rate and results in a better clinical outcome than the one-end K-wire bending fixation method, as reported in 3.
- The MATB technique is the most widely accepted method of internal fixation for transverse and comminuted patellar fractures, as stated in 2.
- Good to excellent clinical results (64-100 %) have been reported with MATB for fixation of patellar fractures, as mentioned in 2.
Alternative Techniques
Alternative techniques for managing patella fractures include: