Clin Orthop Surg.  2019 Jun;11(2):244-248. 10.4055/cios.2019.11.2.244.

Modified Tension Band Wiring Using FiberWire for Patellar Fractures

• Lee BJ
• Chon J
• Yoon JY
• Jung D

• KMID: 2445062
• DOI: http://doi.org/10.4055/cios.2019.11.2.244

Abstract

In comminuted patellar fractures, we performed modified tension band wiring using a FiberWire (Arthrex) instead of the conventional methods. From March 2016 to March 2018, 63 patients with patellar fractures who needed surgical treatment were treated with modified tension band wiring using two Kirschner wires (K-wires) and FiberWire. We inserted two 1.6-mm K-wires perpendicular to the fracture line after accurate reduction. With the knee flexed over 90°, we sutured around the patella using a FiberWire. Visual analog scale score and Levack's score were improved postoperatively. The mean bone union time was 5.6 months. None of the patients had breakage of wires, and nonunion with deformity occurred in one patient. We think that our method can be easier to handle and reduce irritation or breakage of the wires than conventional methods. In addition, early rehabilitation can be allowed. Therefore, we suggest that this method could be a useful method for the treatment of patellar fractures.

Keyword

Patella; FiberWire; Tension band wiring

Figure

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  Fig. 1 Modified tension band wiring using FiberWire. (A) After accurate reduction with reduction forceps, Kirschner wires (K-wires) were inserted from the superior to the inferior pole, perpendicular to the fracture line. (B) In the comminuted fracture of the lower pole, K-wires were passed from the fracture surface of the distal fragment to the inferior pole, and reduction was performed before passage of the K-wires through the superior pole. (C) Then, the knee was flexed over 90°. (D) Sutures were performed around the patella using FiberWire.

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  Fig. 2 (A) Preoperative radiograph and three-dimensional computed tomographic scan of a 64-year-old male showing comminuted patellar fracture (AO/ASIF classification, 34-C3 type). (B) Postoperative radiographs showing reduction status of the patella after modified tension band wiring using FiberWire. (C) Postoperative radiographs taken 10 weeks after surgery showing bone union.

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  Fig. 3 Preoperative radiograph (A) and three-dimensional computed tomographic scan (B) of a 78-year-old male showing comminuted patellar fracture (AO/ASIF classification, 34-C3 type). (C, D) Postoperative radiographs showing reduction status of the patella after modified tension band wiring using FiberWire. (E) Postoperative radiograph taken 6 weeks after surgery showing loss of reduction.

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