J Korean Fract Soc.  2013 Oct;26(4):321-326. 10.12671/jkfs.2013.26.4.321.

Modified Tension Band Wiring Combined with Anti-Gliding Loop Augmentation Technique for the Treatment of Comminuted Patellar Fracture: Technical Note and Report of Early Results: Technical Note

• Lee HJ
• Yang JJ
• Jung HJ
• Jung HS

• KMID: 2183834
• DOI: http://doi.org/10.12671/jkfs.2013.26.4.321

Abstract

In order to investigate the feasibility of a modified tension band combined with anti-gliding loop augmentation technique for the treatment of comminuted patellar fracture, 21 patients with comminuted patellar fracture were enrolled in this study. After the modified tension band wiring of patellar fracture, a cerclage wire was passed around the patella. Anti-gliding loops were made on the bending sites of Kirshner-wires. A knot was tied using both ends of the anti-gliding loops, and the cerclage wire was tightened using proximal knots. Bone union was achieved at 4.5+/-1.5 months postoperatively without nonunion. The Lysholm score was 87.1+/-2.8, and the range of motion of the knee was 2.1degrees+/-3.4degrees to 132.2degrees+/-6.5degrees at the last follow-up. The modified tension band combined with anti-gliding loop augmentation technique might be considered an alternative modification of modified tension band wiring for the treatment of comminuted patellar fracture.

Keyword

Patellar fracture; Comminuted fractures; Modified tension band; Cerclage wire; Anti-gliding loop

MeSH Terms

Follow-Up Studies
Fractures, Comminuted
Humans
Knee
Patella
Range of Motion, Articular

Figure

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  Fig. 1 A cerclage wire is prepared for the anti-gliding loops with proximal two knots like a Mickey Mouse hat.

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  Fig. 2 The cerclage wire is passed around the soft tissue of the patella.

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  Fig. 3 Anti-gliding loops are made on the bending sites of K-wires.

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  Fig. 4 A knot is tied between both ends of the anti-gliding loops, and the cerclage wire is tightened using the proximal knots.

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  Fig. 5 Fluoroscopic image of modified tension band fixation and the tightened cerclage wire with anti-gliding loops.

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  Fig. 6 Intraoperative picture demonstrating modified tension band fixation and the tightened cerclage wire with anti-gliding loops. Dotted rectangular area demonstrating anti-gliding loops.

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  Fig. 7 Magnified picture of the dotted rectangular area of Fig. 6 demonstrating anti-gliding loops.

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