Online ISSN: 2515-8260

Keywords : Tension Band Wiring


T.Zeeshan Muzahid, T. Zahid Hussain

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1192-1204

Background:Orthopaedic doctors treat ankle fractures frequently. Few studies have studied functional recovery after ankle fracture surgery, and none have analysed predictors. Ankle injuries can be caused by low-energy rotational forces in sports, a misstep in daily activities, or RTA. Young and middle-aged are more at risk. Early and optimal ankle function restoration is a prerequisite. Surgical reduction and internal fixation are used to treat most ankle fractures. In ankle fractures, the anatomic repair is the goal. For ankle fractures, open reduction and internal fixation are typical. This study analyses the causes, patterns, and surgical outcomes of ankle fractures.
Materials and Methods: It is a prospective study which was carried out from December 2017 to December 2018 in Great Eastern Medical School & College. In this study period 30 cases of ankle fractures, meeting the inclusion and exclusion criteria were treated by open reduction and internal fixation using appropriate implants.
Results: Most incidences (38%) were in the 31-40 age group. In this study, the right ankle was involved in 35 (70%) cases and the left in 15.0 (30%). 9 (30%) of our cases were between the ages of 31-40, followed by 8 (26.7%) between 41-50. The eldest patient was 65. 42.07 was the mean age. In this series, the right ankle was involved in 20 (66.7%) instances and the left ankle in 10 (33.3%) cases. 26.7% of fracture patients were farmers and 20% were housewives. 14 (46.7%) instances exhibited supination-external rotation damage, followed by 8 (26.7%) pronation-abduction injury. In this study, 30 bimalleolar ankle fractures were treated by open reduction and internal fixation. Excellent results were seen in 8 (26.7%) patients, good in 17 (56.7%), and fair in 5. (16.7 percent). No patient did poorly. Good to outstanding functional outcomes in 83.4% of cases and fair results in 16.6%.
Conclusion: Surgery for bimalleolar ankle fractures yields good functional results. Early weight bearing and mobility are obtained. Anatomical reduction and articular congruence restoration are necessary for all intraarticular fractures, especially if a weight-bearing joint like the ankle is involved. Openreduction and internal fixation restore ankle joint congruency.

A study to assess the functional outcomes of surgical intervention in patellar fractures and make a comparison between tension band wiring and partial patellectomy

Dr. Manoj Bhagirathi Mallikarjunaswamy, Dr. Nikunj Aggarwal, Dr. Shivanna

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 522-528

Introduction: Surgical treatment of patellar fractures has evolved over the years. It ranges from partial
or total patellectomy to open reduction internal fixation using tension band wiring and constructs.
Previous studies have documented conflicting results regarding clinical and functional outcomes after
surgical treatment of patellar fractures.
Aim: To assess the functional outcomes of surgical intervention in patellar fractures and make a
comparison between tension band wiring and partial patellectomy.
Methods: 46 patients with patellar fractures were included in this prospective longitudinal study.
Depending on the fracture type surgical intervention in the form of tension band wiring of the patella in
24 patients and partial patellectomy in 22 patients was done. Postoperatively, the functional outcomes
were measured at three months, six months, and the latest follow-up. The outcome variables used were
Knee Injury and Osteoarthritis Outcome Score (KOOS), extensor lag, range of knee flexion, thigh
circumference, Medical Research Council (MRC) grading of quadriceps and hamstrings strength and
complications in treated patients. Levene’s test, T test and chi-square test were used to compare the
these outcome variables.
Results: KOOS score was significantly better (P value of 0.001) and thigh wasting was less (P value of
0.09 and 0.412) at three and six months in the tension band wiring (TBW) group. Knee flexion (P value
of 0.001) and extensor lag (P value of 0.02) had significantly better outcome in the TBW group at three
months, but a similar outcome to the partial patellectomy group at six months (P value >0.05). All the
patients had regained their full quadriceps/hamstring muscle strength at six months. Fracture union was
assessed at six months and showed a significantly better union rate in tension band wiring when
compared to partial patellectomy (P value < 0.05).
Conclusions: Operative management of patellar fractures gives good to excellent functional outcomes
at short to midterm follow-up with minimal complications, irrespective of the type of procedure.
Comparable functional outcomes can be expected following patellar osteosynthesis and salvage
procedure. However, future studies with bigger sample size and longer follow-up are needed.