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Indian Pre-Basic Course: Tension Band Wiring DR DEEPAK K RAI YENEPOYA MEDICAL COLLEGE MANGALORE.

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Page 1: tension band wiring

Indian Pre-Basic Course:

Tension Band Wiring

DR DEEPAK K RAIYENEPOYA MEDICAL COLLEGE MANGALORE.

Page 2: tension band wiring

Biomechanics – Pauwels 1935

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Biomechanics

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Biomechanics

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Biomechanics

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The cortex from the TBW must be strong enough to bear

the applied compressive loads

Biomechanics

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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.

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Tension Band Wiring is a device, which convert distraction

forces of extensors acting on the fracture line into

compressive forces

Biomechanics

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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.

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Olecranon

Greater trochanter Patella

Greatertuberosity

Lateral malleolus

Clinical Applications of tension band wiring

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Anatomy of Olecranon and Patella- eccentric forces

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Classification of olecranon fractures – AO and Schatzker

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Transverse olecranon fracture

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Transverse impacted fracture

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Oblique fracture – fixation with lag screw and tension band wire

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Comminuted fracture- tension band plate and lag screw

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Displaced fractures of patella should be treated surgically

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

Transverse, simple

S.W. 39yo. Tripped

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Highly comminuted patellar fracture

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Treatment options for comminuted patella fractures

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Comminuted fracture –circlage wire and K wire fixation

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Tension Band Wiring step by step

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

Polar

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Other indications for tension band wiring- greater tuberosity of Humerus

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Further indications for tension band wiring – greater trochanter of femur

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Summary

Tension Band Wiring is a device, which convert distraction

forces of extensors acting on the fracture line into

compressive forces

Page 27: tension band wiring

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