A COMPARATIVE STUDY OF TENSION BAND WIRING AND CIRCUMFERENTIAL WIRING IN THE MANAGEMENT OF PATELLAR FRACTURES
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Keywords
Patella fractures, Tension band wiring, Circumferential wiring, Knee extension, Functional outcome, Orthopaedic fixation.
Abstract
Background: Patellar fractures often compromise knee extension and daily functional activities. Among operative options, tension band wiring (TBW) and circumferential wiring (CW) remain widely used, yet comparative evidence continues to evolve.
Aim: To evaluate and compare radiological union, functional recovery, and complication rates between TBW and CW in adult patellar fractures.
Methods: A prospective comparative study was conducted over one year on 36 adult patients divided equally into TBW (n=18) and CW (n=18). Radiological assessment, knee range of motion, early mobilization milestones, and functional outcomes were measured using WEST criteria.
Results: Mean time to union in the TBW group was 9.1 ± 1.4 weeks, compared with 11.2 ± 1.7 weeks in the CW group. At 12 weeks, 83.3% of TBW patients achieved knee flexion beyond 100°, compared with 61.1% of CW patients. According to WEST criteria, TBW resulted in excellent or good outcomes in 88.8% of cases versus 77.7% in the CW cohort. Extension lag was seen in 2 CW patients and 1 TBW patient.
Conclusion: TBW provided faster union, better early knee flexion, and superior functional outcomes compared with CW. The conclusion supports TBW as the more effective technique for most displaced patellar fractures due to stable fixation and easier postoperative rehabilitation.
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Dr. P. Srinivas Rao
Assistant Professor, Narayana Medical College and Hospital. 10/56, Yadhav Street, Bujabuja Nellore, Nellore – 524004, Andhra Pradesh, India.
Dr. Biju Ravindran
Professor and HOD, Department of Orthopaedics, Narayana Medical College and Hospital, Nellore.
Dr. A. Harikrishna
Post Graduate, Narayana Medical College, Nellore.