Comparison of displaced patellar fracture treatment by two methods: Cerclage circumferential wiring versus tension band wiring
Abstract
Objective: There are a variety of methods for operative treatment of patellar fractures. The aim of this study was to compare the outcome of cerclage wiring (CW) versus Tension Band Wiring (TBW) for treatment of displaced fractures of the patella.
Methodology: In this retrospective study we reviewed the medical files of the patients who had displaced transverse or comminuted patella fractures treated at two trauma hospitals between 2004 to 2010. Forty four patients were found that had been operated with either of these two methods: TBW=24, CW=20. Outcome was evaluated by Bostman rating score, at a mean follow-up time of 2.3 years.
Results: Mean age of all patients was 32.7 years. There was no significant difference regarding the mean age, gender, and mechanism of the fractures in patients treated by two methods of TBW and CW. Atrophy of quadriceps muscle was (1.146 cm ± 0.9cm) in 19 patients with TBW, and (2.3 ± 0.6cm) in all patients with CW, which shows significant difference. No case of infection or nonunion had occurred. Good to excellent results in TBW and CW were found in 83.4% and 80% of patients respectively that reveals no major difference. Hardware removal due to pin irritation was performed in 66.6% of TBW and 10% of CW group. There was no significant difference between two groups with respect of PF osteoarthritis.
Conclusion: Despite less secure fixation with CW, both TBW and CW methods had comparable outcome with a high rate of good to excellent results in the treatment of displaced patella fractures. Individualized treatment plan based on the type and pattern of the fracture is suggested.
Methodology: In this retrospective study we reviewed the medical files of the patients who had displaced transverse or comminuted patella fractures treated at two trauma hospitals between 2004 to 2010. Forty four patients were found that had been operated with either of these two methods: TBW=24, CW=20. Outcome was evaluated by Bostman rating score, at a mean follow-up time of 2.3 years.
Results: Mean age of all patients was 32.7 years. There was no significant difference regarding the mean age, gender, and mechanism of the fractures in patients treated by two methods of TBW and CW. Atrophy of quadriceps muscle was (1.146 cm ± 0.9cm) in 19 patients with TBW, and (2.3 ± 0.6cm) in all patients with CW, which shows significant difference. No case of infection or nonunion had occurred. Good to excellent results in TBW and CW were found in 83.4% and 80% of patients respectively that reveals no major difference. Hardware removal due to pin irritation was performed in 66.6% of TBW and 10% of CW group. There was no significant difference between two groups with respect of PF osteoarthritis.
Conclusion: Despite less secure fixation with CW, both TBW and CW methods had comparable outcome with a high rate of good to excellent results in the treatment of displaced patella fractures. Individualized treatment plan based on the type and pattern of the fracture is suggested.
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