Modified Triple-Bundle Tension Band Wiring for Comminuted Patella Fractures: A Case Report

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Abstract

Patellar fractures, which compromise the knee's extensor mechanism, are commonly encountered orthopedic injuries. Tension band wiring (TBW) is the standard approach for managing simple transverse fractures but is not without complications such as wire migration and breakage. This case report introduces a modified TBW method intended to enhance mechanical stability and mitigate common hardware-related issues. A 51-year-old woman presented with right knee pain and swelling after a fall. Radiographs showed a transverse patellar fracture. She underwent surgical fixation using a triple-bundle wire technique designed to boost construct integrity and prevent wire migration. Postoperative management involved early mobilization with continuous passive motion and gradual progression to full weight-bearing. At a three-month follow-up, the patient exhibited complete fracture healing and excellent knee function, with no implant-related issues. This modified TBW approach proved to be biomechanically stable, safe, and conducive to early recovery, warranting consideration for wider clinical application.