Modified Tension band wiring vs Tension band with cannulated cancellous screws in treating transverse patellar fractures

Purpose: Despite being the most favoured modality of treatment in patellar fractures, modified tension band wiring (MTBW) technique has serious demerits with regards to clinical outcomes. Tension band with cannulated cancellous screws (TBCC) is a recent technique to overcome the demerits associated with former technique.  This study was aimed to compare these two techniques, in terms of clinical outcomes, in treating patellar fractures. Methods: This hospital based prospective randomized study was conducted in a tertiary care hospital for 2 years. Thirty patients with Gustillo-Anderson grade 1 and 2 compound fractures were randomly divided into two treatment groups, viz MTBW and TBCC groups. After performing pre-operative investigations, patients were anesthetized, and knee was operated by the standard procedures. Post-surgery, radiographs were taken and range of motion, pain score (Visual Analogue Scale (VAS)), time taken for radiological union, clinical outcomes were recorded. Results: Mean age of the patients included in the MTBW and TBCC group were 53 years and 58.5 years, respectively. Between the groups, range of motion, IOWA score assessed at the end of 6 months, did not vary significantly (P>0.05).  Meanwhile, the difference noticed with average time taken for radiological union was also nonsignificant (MTBW =11 weeks. TBCC=10 weeks)