Acta Scientific Orthopaedics (ISSN: 2581-8635)

Technical Paper Volume 5 Issue 12

Understanding the Basic Principles and Biomechanics of Patellar Modified Tension Band Wiring Surgery: are we on a Monotonous Path for Fixing Transverse Patellar Fractures?

Rohil Singh Kakkar*

Department of Trauma and Orthopaedic Surgery, Sahyadri Hospital, Pune, India

*Corresponding Author: Rohil Singh Kakkar, Department of Trauma and Orthopaedic Surgery, Sahyadri Hospital, Pune, India.

Received: September 29, 2022; Published: November 11, 2022


Fractures of patella constitute up to 1% of all skeletal injuries with 70-80% of these having a transverse fracture pattern in adults with the absolute indication for surgical treatment being an extensor mechanism disruption [1-4,7]. The aim of surgical treatment in patella fracture is anatomical reduction, restoration of articular congruity, preserving patellar bone stock, and repairing the extensor mechanism. The modified tension band wiring (TBW) technique, which converts the tensile forces generated by the knee extensor into compressive forces at the joint line, has been widely acknowledged as the optimum treatment for displaced transverse patellar fractures due to its biomechanical superiority and economical benefits.


  1. Mehling I., et al. “Comminuted patellar fractures”. Current Orthopaedic 6 (2006): 397-404.
  2. Campbell’s Operative Orthopaedics, 13th International Edition.
  3. Melvin JS and Metha S. “Patellar fractures in adults”. Journal of the American Academy of Orthopaedic Surgeons 4 (2011): 198-207.
  4. Crenshaw AH and Wilson FD. “The surgical treatment of fractures of the patella”. Southern Medical Journal 8 (1954): 716-720.
  5. Carpenter JE., et al. “Fractures of patella”. The Journal of Bone and Joint Surgery 75 (1993): 1550-1561.
  6. Ali M., et al. “Biomechanical analysis of tension band wiring (TBW) of transverse fractures of patella”. Chinese Journal of Traumatology 5 (2016): 255-258.
  7. Yang TY., et al. “Treatment of displaced transverse fractures of the patella: modified tension band wiring technique with or without augmented circumferential cerclagewire fixation”. BMC Musculoskeletal Disorders 1 (2018): 167.
  8. Dudani B and Sanchet KM. “Management of fracture patellae by tension band wiring”. Indian Journal of Orthopaedics 15-1 (1981): 43-48.
  9. Mohapatra S., et al. “International Surgery Journal5 (2017): 1558-1565.
  10. Kohli S., et al. “Scholars Journal of Applied Medical Sciences 6B (2016): 1997-2002.
  11. Zderic I., et al. “Biomechanical evaluation of the tension band wiring principle. A comparison between two different techniques for transverse patella fracture fixation”. Injury 8 (2017): 1749-1757.
  12. Müller ME., et al. “Manual of internal fixation: techniques recommended by the AO-ASIF group”. Berlin: Springer (1991).
  13. BROOKE R. “The Treatment of Fractured Patella by Excision. A Study of Morphology and Function”. British Journal of Surgery 24 (1937): 733.
  14. Der schenkelhalsbruch. “Ein mechanisches Problem. By Dr. Friedrich Pauwels (Aachen). Royal 8vo. Pp. 157, with 186 illustrations. 1935. Stuttgart: Ferdinand Enke. Paper covers, RM. 13.60; bound, RM. 15.00”. British Journal of Surgery92 (1936): 874.
  15. Bostrom MP., et al. “Fatigue testing of cerclage stainless steel wire fixation”. Journal of Orthopaedic Trauma 5 (1994): 422-428.
  16. Koval KJ and Kim YH. “Patella fractures. Evaluation and treatment”. The American Journal of Knee Surgery 2 (1997): 101-108.
  17. Nikiforidis P., et al. “Patellar fractures: contemporary approach to operative treatment, using different types of the tension band principles”. European Journal of Orthopaedic Surgery and Traumatology 9 (1999): 21-26.
  18. John J., et al. “Tension-band wiring of transverse fractures of patella. The effect of site of wire twists and orientation of stainless-steel wire loop: a biomechanical investigation”. International Orthopaedics5 (2007): 703-707.


Citation: Rohil Singh Kakkar. “Understanding the Basic Principles and Biomechanics of Patellar Modified Tension Band Wiring Surgery: are we on a Monotonous Path for Fixing Transverse Patellar Fractures?”.Acta Scientific Orthopaedics 5.12 (2022): 99-102.


Copyright: © 2022 Rohil Singh Kakkar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate33%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is June 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US