tension band wiring

Indian Pre-Basic Course:

Tension Band Wiring

DR DEEPAK K RAIYENEPOYA MEDICAL COLLEGE MANGALORE.

Biomechanics – Pauwels 1935

Biomechanics

Biomechanics

Biomechanics

The cortex from the TBW must be strong enough to bear

the applied compressive loads

Biomechanics

Biomechanics

The implant alone does not provide stability. In combination with

antagonistic deforming muscles, it can help produce uniform

compression at the fracture site. It guides the compression force.

The parallel wires serve as rails along which the bone fragments

slide.

Tension Band Wiring is a device, which convert distraction

forces of extensors acting on the fracture line into

compressive forces

Biomechanics

PREREQUISITES OF TENSION BAND FIXATION

1 . A PLATE OR WIRE THAT IS ABLE TO WITHSTAND THE TENSILE FORCES.

2 . BONE WHICH IS ABLE TO WITHSTAND A COMPRESSIVE FORCE.

3 . AN INTACT BUTTRESS OF THE OPPOSITE CORTEX.

Olecranon

Greater trochanter Patella

Greatertuberosity

Lateral malleolus

Clinical Applications of tension band wiring

Anatomy of Olecranon and Patella- eccentric forces

Classification of olecranon fractures – AO and Schatzker

Transverse olecranon fracture

Transverse impacted fracture

Oblique fracture – fixation with lag screw and tension band wire

Comminuted fracture- tension band plate and lag screw

Displaced fractures of patella should be treated surgically

Displaced patellar fractures – classic figure of eight tension band wire fixation

Transverse, simple

S.W. 39yo. Tripped

Highly comminuted patellar fracture

Treatment options for comminuted patella fractures

Comminuted fracture –circlage wire and K wire fixation

Tension Band Wiring step by step

Displaced patellar fractures- treatment options for lower pole fractures or patellar tendon rupture

Polar

Other indications for tension band wiring- greater tuberosity of Humerus

Further indications for tension band wiring – greater trochanter of femur

Summary

Tension Band Wiring is a device, which convert distraction

forces of extensors acting on the fracture line into

compressive forces

Summary

The implant alone does not provide stability. In combination with

antagonistic deforming muscles, it can help produce uniform

compression at the fracture site. It guides the compression force.

The parallel wires serve as rails along which the bone fragments slide