[Effectiveness of transverse double "8"-shaped tension band technique for Lawrence zone â fracture of the fifth metatarsal base].

Objective: To explore the effectiveness of transverse double "8"-shaped tension band technique in the treatment of Lawrence zoneⅠfracture of the 5th metatarsal base. Methods: Between February 2019 and October 2021, 15 patients with Lawrence zoneⅠfracture of the 5th metatarsal base were treated with transverse double "8"-shaped tension band technique. There were 8 males and 7 females, with a median age of 40 years (range, 23-59 years). The fractures were caused by sprains. The time from injury to operation was 3-7 days (mean, 4.1 days). X-ray films were taken to observe the fracture healing and the anchor looseness and detachment. The foot function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, and the eversion angle of the calcaneal talus joint. Results: The incisions healed by first intention after operation in 14 cases and the incision healed poorly in 1 case. All patients were followed up 8-12 months (median, 10 months). The imaging examination showed that all fractures healed well, with a healing time of 10-14 weeks (mean, 11.7 weeks). At last follow-up, AOFAS score was 82-100 (median, 98); 13 cases were excellent and 2 cases were good, with an excellent and good rate of 100%. VAS score was 0-3 (median, 1). Three cases had mild limited ankle joint range of motion, while 12 cases had normal range of motion. The eversion angle of the calcaneal talus joint was 25°-32° (median, 30°). Conclusion: The application of transverse double "8"-shaped tension band technique for Lawrence zone Ⅰ fracture of the 5th metatarsal base has advantages such as simple operation, avoidance of secondary operation, and reduction of foreign body sensation, with definite effectiveness.

Loop Anchor Tension Band Technique for Patella Fractures Lowers the Rate of Kirschner Migration.

OBJECTIVE: To compare the complications of patella fracture after open reduction and internal fixation using our innovative, loop-based modification of the tension band wiring technique and the traditional tension band wiring technique. METHODS: Fifty-eight patients with patella fracture (AO/OTA: 34-C) were enrolled in this retrospective case-control study during the study period. We treated 36 patients with the traditional tension band wiring and 22 patients with our loop anchor tension band technique. Lysholm knee scoring scale, sex, numbers of wire dislodge, number of implants removal between two groups were compared. RESULTS: The number of cases of wire dislodgement was zero in the loop anchor tension band group and seven in the traditional tension band group. There was statistically significant difference (P = 0.037). Lysholm knee score (P = 0.685) and operation time (P = 0.395) were not significantly different between the two groups CONCLUSIONS: The loop anchor tension band technique is safe and effective for treating patella fractures. The rates of implant loosening and wire pull-out were significantly lower in the loop anchor tension band group than those in the traditional technique group.

Guided growth for valgus deformity correction of knees in a girl with osteopetrosis: a case report.

Autosomal dominant osteopetrosis (Albers-Schönberg disease) classically displays the radiographic signs of osteosclerosis. The main ADO complications involve the skeleton: low-impact bone fractures, scoliosis and hip osteoarthritis. Management of osteopetrosis-related orthopedic problems is a surgical challenge due to increased bone density. The healing process is very slow in these patients because of bone remodeling defects related to osteoblast function failure. In case of bone deformities, a realignment method should be appropriated to osteopetrosis conditions. This article presents a case report of operative treatment of an 11-year-old girl affected with ADO, who underwent a simultaneous valgus knee deformity correction of both limbs with medial eight-plate epiphysiodesis. Simultaneous correction of valgus deformity on both limbs using an extraperiosteal tension plate technique for medial tibial hemiepiphysiodesis was performed in a girl of 11.5 years old with autosomal dominant osteopetrosis. The treatment duration from surgery to complete deformity correction and removal of plates was 18 months. The final aMPTA was 86° on the right side and 85° on the left side. The correction rate was 0.61°/month (right tibia) and 0.67°/month (left tibia). The MAD correction rate was evaluated as 1.5 mm/month for the right limb and 1.6 mm/month for the left limb. At the moment of plate removal, one screw was broken because of tight fixation in osteopetrotic bone. But it did not compromise the final result. The latest follow-up visit at the age of 14 years 6 months revealed excellent realignment without any deformity relapse. There was no any functional impairment. We consider the guided growth by tension band technique as very interesting and promising solution for treatment of pediatric angular deformity in patients with OP. This method allows to avoid osteotomy and related important risk of delayed union or nonunion frequently observed in osteopetrosis. LEVEL OF EVIDENCE: Level IV.

Percutaneous cannulated screws with tension band wiring technique in patella fractures.

INTRODUCTION: Most patellar fractures are transverse involving the central third. Open reduction and stabilization of transverse patellar fractures is indicated if there is more than 2-3 mm of fragment separation and/or articular incongruity. SURGICAL TECHNIQUE: This study describes a percutaneous 2 cannulated screws and modified tension band wiring technique to treat transverse patellar fractures. MATERIALS AND METHODS: We performed 30 cases of displaced transverse patellar fractures with this technique. The clinical outcomes of these patients were evaluated with simple radiographs, range of motion and Lyshom score. RESULTS: This technique has shown to provide satisfactory clinical results and excellent knee functions. CONCLUSIONS: This technique provide stable fixation, allows early motion exercise by minimizing injury to extensor mechanism and reduce cosmetic problem in scar.

Percutaneous Cannulated Screws with Tension Band Wiring Technique in Patella Fractures

INTRODUCTION: Most patellar fractures are transverse involving the central third. Open reduction and stabilization of transverse patellar fractures is indicated if there is more than 2-3 mm of fragment separation and/or articular incongruity. SURGICAL TECHNIQUE: This study describes a percutaneous 2 cannulated screws and modified tension band wiring technique to treat transverse patellar fractures. MATERIALS AND METHODS: We performed 30 cases of displaced transverse patellar fractures with this technique. The clinical outcomes of these patients were evaluated with simple radiographs, range of motion and Lyshom score. RESULTS: This technique has shown to provide satisfactory clinical results and excellent knee functions. CONCLUSIONS: This technique provide stable fixation, allows early motion exercise by minimizing injury to extensor mechanism and reduce cosmetic problem in scar.

Estudio comparativo de artrodesis de dedos: banda de tensión vs tornillo compresivo / Finger atrhodesis: a comparative study with tension band a fusion technique

Objective: There are many different techniques for finger arthrodesis our purpose is to compare the results of metarcophalangeal (MP) and proximal interphalangeal (PIP) joint arthrodesis, with tension band wire technique vs compression screw. Methods: Retrospective cohort study of patients with arthrodesis of the MP and PIP joint between 2006 and 2009, with a tension band wire technique (N = 28) and Mini-Acutrak screw (N = 29). We compared rates and times of union and the incidence of complications. Results: The union rate of the tension band group was 92.9 percent and 85.7 percent for the screw group, at 9.4 and 9.8 weeks respectively. The complications rate was 28.6 percent for tension band wire technique and 27.6 for the screw technique. The reoperation rate was 32.1 percent for the tension band wire technique and 3.6 percent for the screw group, with remove of 25 percent of the tension band. Discussion: Both surgical techniques had a similar rate of union and complications, but with significantly more re-operation to remove implants in the tension band group, which is an important factor to consider when choosing the surgical technique.

Objetivo: Existen múltiples técnicas de atrodesis de dedos, por lo que nuestro objetivo es compara resultados de artrodesis de metacarpofalángicas e interfalángicas proximales de los dedos mediante banda de tensión vs tornillo compresivo. Material y Método: Se realizó un estudio de cohorte retrospectivo, comparativo, de pacientes operados de artrodesis interfalángica proximal o metacarpofalángica de lo dedos primarias entre los años 2006 y 2009. Se analizaron 28 pacientes con banda de tensión y 29 con técnica de tornillo compresivo sin cabeza Mini-Acutrak, comparando tasas y tiempos de consolidación e incidencia de complicaciones. Resultados: Se obtuvo una tasa de consolidación de 92,9 por ciento para el grupo banda de tensión y 85,7 por ciento para el grupo de tornillos, a las 9,4 y 9,8 semanas respectivamente (sin diferencia significativa para ambas variables). La tasa de complicaciones fue de 28,6 por ciento para la bandea de tensión y de 27,6 por ciento para la técnica con tornillo. La tasa de reoperaciones fue de 32,1 por ciento para la técnica con banda de tensión y de 3,6 por ciento con tornillo, determinado por el 25 por ciento de las bandas de tensión, sin haber retiro de tornillos. Discusión; Ambas técnicas quirúrgicas muestran una similar tasa de consolidación y complicaciones, pero existe unna significativa mayor tasa de reoperaciones para el retiro de material de osteosíntesis en el grupo de banda de tensión, lo cual es un factor importante a considerar en la elección de la técnica quirúrgica, siendo en este sentido, el tornillo una mejor opción.

Improvement of the Elbow Function with Early Mobilization and Rigid Fixation of Coronoid Fracture by Tension Band Technique

PURPOSE: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique MATERIALS AND METHODS: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. RESULTS: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was 3degrees (range: 0degrees~25degrees), the mean flexion was 137degrees (range: 130degrees~140degrees), the mean pronation was 69degrees (range: 45degrees~90degrees) and the mean supination was 78degrees (range: 45degrees~90degrees). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. CONCLUSION: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

Modified Tension Band Technique With Looped Pin

PURPOSE: Fixation of fracture using modified tension band is a very useful treatment method, but loss of fixation caused by loosening of K-wires still remain problem. So we have studied the usefulness of modified tension band with looped pin in order to prevent loss of internal fixation. MATERIALS AND METHODS: From September 1999 to June 2002, we had treated 40 patients with this technique, including 16 patella, 8 olecranon, 8 distal clavicle fractures in which three were nonunion fractures, 5 ankle fractures and 3 acromioclavicular joint separations. We looped the pin which has been used for ring external fixator, in line with its long axis. RESULTS: After mean postoperative follow-up of 20 months, there were no loosening of looped pin in all cases and we obtained satisfactory results of functional evaluation. There were no complications of nonunion or metallic irritation. CONCLUSION: We concluded that modified tension band with looped pin could prevent displacement of internal fixation, and reduce the subsequent complications. Especially in elbow and shoulder joint that the displacement of fixation pin occured frequently, It was considered as very useful operative technique.

Operative Treatment Using Minimized Internal Fixation and Tension Band Technique on Proximal Humeral Fracture / 대한정형외과학회잡지

Most proximal humeral fractures respond satisfactorily to simple conservative treatment, but operative treatment is recommended in cases where poor results are anticipated by prolonged immobilization, or because of severe displacement and comminution. We used a minimal internal fixation and tension band technique in severely displaced and comminuted cases to achieve firm fixation and avoid subacromial impingement. Passive range of motion of the involved shoulder began within the first postoperative day and active range of motion exercise was encouraged as soon as possible within the first postoperative week. Between February 1996 and November 1997, we operated using this technique on 15 patients ranging in age from 16 to 71 years (average 52). Follow-up averaged 13 months. During the follow-up period, all patients except one patient, had a active full range of motion on the affected limb. According to the evaluation on the 10 patients who had follow- up periods over 12 months by Hawkins rating scale of shoulder function, 6 patients had achieved a good result and 4 patients had achieved a fair result at the last follow up. In conclusion, tension band technique with minimal internal fixation could afford sufficient fracture stability to allow early, aggressive rehabilitation. As a method of internal fixation on a proximal humerus fracture, this technique may have particular advantages in elderly osteoporotic patients.