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ao principles
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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