Letter to the Editor regarding “Treatment of displaced fractures of the patella: Tension band wiring technique with the one-end or both-ends K-wire bending fixation method”

We read with interest the comparative study on bending of single or double ends of K-wire in Tension band wiring by Huang et al. ¹ AO Foundation recommends bending the K-wire at one end only for easier removal. ² However, migration of K-wire can be a concern in situations like comminuted fracture, uneven fracture fragment, sub-optimal tension of TBW construct or osteoporosed bone quality. The bending of K-wire at both ends is a simple solution to prevent its migration. ^1,3 However, it should be noted that wire removal will require opening of its both ends and straightening of the bent distal end of wire. Other options that can be considered are TBW with cannulated screw construct ⁴ or use of an innovative design labeled as expulsion-proof pin. ⁵ The latter consists of a pre-curved proximal end of pin which has an in-built hole through which tensioning stainless steel wire of 1.5 mm diameter is passed. The pin is available in 1.5, 2 and 2.5 mm diameters. This hardware construct effectively stops the wire migration.

Nirmal Kumar Sinha , Amit Bhardwaj and Ashutosh Sadashiva Rao  Department of Orthopaedics, Melaka-Manipal Medical College, Melaka, Malaysia Department of Orthopaedics, Sengkang General Hospital, Singapore Corresponding author: [e-mail]