Modified Tension Band Wiring Combined with Anti-Gliding Loop Augmentation Technique for the Treatment of Comminuted Patellar Fracture: Technical Note and Report of Early Results- Technical Note

Abstract

In order to investigate the feasibility of a modified tension band combined with anti-gliding loop augmentation technique for the treatment of comminuted patellar fracture, 21 patients with comminuted patellar fracture were enrolled in this study. After the modified tension band wiring of patellar fracture, a cerclage wire was passed around the patella. Anti-gliding loops were made on the bending sites of Kirshner-wires. A knot was tied using both ends of the anti-gliding loops, and the cerclage wire was tightened using proximal knots. Bone union was achieved at 4.5±1.5 months postoperatively without nonunion. The Lysholm score was 87.1±2.8, and the range of motion of the knee was 2.1o±3.4o to 132.2o±6.5o at the last follow-up. The modified tension band combined with anti-gliding loop augmentation technique might be considered an alter-native modification of modified tension band wiring for the treatment of comminuted patellar fracture.

슬개골 분쇄 골절의 치료를 위한 anti-gliding loop로 강화된 변형 긴장대 강선 술식의 유용성을 알아보고자 하였다. 슬개골분쇄 골절로 진단받은 21명의 환자를 대상으로 하였다. 수술 방법으로는 변형 긴장대 강선 술식과 함께 슬개골 주위로 cerclagewire를 통과시키고 K-wire의 bending site에 anti-gliding loop를 만든 후 cerclage wire를 팽팽하게 조이는 방법으로 시행하였으며, 모든 환자는 수술 후 12개월 이상 추시 관찰하였다. 골유합은 술 후 4.5개월에 관찰되었으며, 불유합이나 K-wire의slippage는 관찰되지 않았다. 최종 추시에서 Lysholm score는 87.1이었으며, 슬관절의 운동범위는 2.1o-132.2o였다. Anti-gliding loop로 강화된 변형 긴장대 강선 술식은 슬개골 분쇄 골절의 치료에 있어서 변형 긴장대 강선 술식의 유용한개량술로 사용될 수 있을 것으로 판단된다.