Study of functional outcome of modified tension band wiring in transverse fracture patella

INTRODUCTION: Fracture of the eccentrically loaded bone like patella is one of the most common fracture encountered by an orthopaedic surgeon. They continue to pose vexing problems as these being intraarticular are subjected to continuous deforming forces from muscles. It is also difficult to restore the desired anatomical continuity and congruity of their articular surfaces after reduction and thereby causing complications like osteoarthritis, stiffness of joints, non-union etc.In this era, fractures of patella are on an increasing note mainly resulting from road traffic accidents and hectic working schedule of a common man. Hence, with better operative techniques, internal fixation of these fractures with tension band wiring has become an accepted mode of treatment with its matching outcome results enabling the patient to smoothly resume his work without hampering his day-to-day life. Internal fixation of fractures hastens healing and rehabilitation. It also allows for early mobilization of the joint thereby preventing stiffness of joints and other complications related to immobilization. MATERIALS AND METHODS: The study will be conducted in Coimbatore medical college and hospital during the period 2012-2015. 20 patients with transverse fractures will be included in the study. Inclusion criteria: 1. Age above 16 years, 2. Includes both sex, 3. Fresh and old fractures. Exclusion criteria: 1. Age less than 18 years, 2. Infected fractures. CONCLUSION: It was concluded from the present study that: 1. Tension band wiring by principle overcomes the deforming force, achieves compression at the fracture site and maintains the alignment by minimum hardware. 2. The fixation enables early active movements of joints as early as four weeks when the fracture is healing, which reduces joint stiffness. 3. The long-term complications of prolonged Joint Stiffness, Immobilization like Muscle Wasting, Pressure Sores, and osteoporosis are avoided. 4. By achieving compression at fracture site, the fracture heals faster and the patient is back to work earlier. 5. Hence, it is concluded that tension band wiring is a simple, inexpensive technique and effective means of fixing fracture based on biomechanical principle with minimum complication